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General NPI Number Information
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NPI Number | 1497911481
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Entity Type | Organization
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Legal Business Name | BRIAN M. TERUYA, OD AND MARK S. TERUYA, OD OPTOMETRY
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Dates
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Enumeration Date | 07/30/2008
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Last Update Date | 07/30/2008
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Provider Practice Location Address
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Address Line | 3221 WAIALAE AVE SUITE 340
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City | HONOLULU
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State | HI
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Zip | 96816-5842
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Country | US
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Telephone | 808-734-4343
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Fax | 808-734-3930
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Provider Business Mailing Address
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Address Line | 3221 WAIALAE AVE SUITE 340
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City | HONOLULU
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State | HI
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Zip | 96816-5842
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Country | US
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Telephone | 808-734-4343
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Fax | 808-734-3930
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Authorized Official
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Title or Position | GEN. PARTNER
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Name | DR. BRIAN M TERUYA
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Credential | O.D.
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Telephone | 808-734-4343
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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 | OD176
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OD167
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License Number State | HI
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