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General NPI Number Information
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NPI Number | 1043356884
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Entity Type | Organization
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Legal Business Name | PEARL HARBOR VISION CENTER
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4725 BOUGAINVILLE DR
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City | HONOLULU
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State | HI
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Zip | 96818-3179
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Country | US
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Telephone | 808-422-2210
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Fax | 808-422-2262
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Provider Business Mailing Address
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Address Line | 1025 QUINCY AVE SUITE 1020
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City | PEARL HARBOR
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State | HI
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Zip | 96860-4512
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Country | US
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Telephone | 808-422-2210
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Fax | 808-422-2262
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PEILI LIN
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Credential | O.D.
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Telephone | 808-422-2210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 498
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License Number State | HI
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