Healthcare Provider Details

I. General information

NPI: 1508980095
Provider Name (Legal Business Name): YVETTE NS HIDA O D INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 KILANI AVE
WAHIAWA HI
96786-1904
US

IV. Provider business mailing address

610 KILANI AVE
WAHIAWA HI
96786-1904
US

V. Phone/Fax

Practice location:
  • Phone: 808-622-2020
  • Fax: 808-622-9009
Mailing address:
  • Phone: 808-622-2020
  • Fax: 808-622-9009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number336
License Number StateHI

VIII. Authorized Official

Name: DR. YVETTE N.S. HIDA
Title or Position: PRESIDENT & DIRECTOR
Credential: O.D.
Phone: 808-622-2020