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General NPI Number Information
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NPI Number | 1336371327
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Entity Type | Organization
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Legal Business Name | MAUI OPTIX LLC
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Dates
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Enumeration Date | 08/10/2009
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 24 KIOPAA STREET, STE 102
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City | MAKAWAO
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State | HI
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Zip | 96768-8295
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Country | US
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Telephone | 808-214-9074
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Fax | 808-214-9071
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Provider Business Mailing Address
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Address Line | PO BOX 29690
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City | HONOLULU
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State | HI
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Zip | 96820-2090
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Country | US
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Telephone | 808-214-9074
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Fax | 808-214-9071
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Authorized Official
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Title or Position | MEMBER
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Name | DR. MICHAEL LEONG
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Credential | OD
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Telephone | 808-214-9074
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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 | 627
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License Number State | HI
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