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General NPI Number Information
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NPI Number | 1316192081
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Entity Type | Organization
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Legal Business Name | KAUAI OPHTHALMOLOGY ASSOCIATES, LLC
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Dates
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Enumeration Date | 11/23/2008
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Last Update Date | 12/20/2008
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Provider Practice Location Address
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Address Line | 3430A KALUA MOA RD
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City | KOLOA
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State | HI
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Zip | 96756-8622
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Country | US
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Telephone | 808-346-7797
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Fax |
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Provider Business Mailing Address
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Address Line | 4366 KUKUI GROVE ST STE 101
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City | LIHUE
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State | HI
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Zip | 96766-2006
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Country | US
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Telephone | 808-346-7797
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Fax |
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Authorized Official
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Title or Position | M.D.
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Name | JEAN SHEIN
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Credential | M.D.
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Telephone | 808-346-7797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD 13717
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License Number State | HI
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