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General NPI Number Information
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NPI Number | 1245544113
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Entity Type | Organization
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Legal Business Name | DR. EARLE H. NAKAGAWA OPTOMETRIST LLC
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Dates
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Enumeration Date | 08/03/2010
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Last Update Date | 08/03/2010
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Provider Practice Location Address
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Address Line | 45-1123 KAM HWY SUITE C
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City | KANEOHE
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State | HI
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Zip | 96744-3242
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Country | US
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Telephone | 808-247-6696
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Fax | 808-247-6663
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Provider Business Mailing Address
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Address Line | 45-1123 KAM HWY SUITE C
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City | KANEOHE
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State | HI
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Zip | 96744-3242
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Country | US
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Telephone | 808-247-6696
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Fax | 808-247-6663
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Authorized Official
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Title or Position | OWVER/OPTOMETRIST
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Name | DR. EARLE HIDETSUGU NAKAGAWA
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Credential | O.D.
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Telephone | 808-247-6696
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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 | 123
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License Number State | HI
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