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General NPI Number Information
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NPI Number | 1053835520
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Entity Type | Organization
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Legal Business Name | OTSUKA EYE CARE LLC
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Dates
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Enumeration Date | 07/27/2017
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Last Update Date | 07/27/2017
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Provider Practice Location Address
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Address Line | 321 N KUAKINI ST STE 811
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City | HONOLULU
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State | HI
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Zip | 96817-2362
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Country | US
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Telephone | 808-531-2731
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Fax |
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Provider Business Mailing Address
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Address Line | 321 N KUAKINI ST STE 811
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City | HONOLULU
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State | HI
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Zip | 96817-2362
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RYAN OTSUKA
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Credential | MD
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Telephone | 808-531-2731
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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