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General NPI Number Information
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NPI Number | 1538167846
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Entity Type | Organization
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Legal Business Name | JOHN M TSUE OD INC
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Dates
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Enumeration Date | 07/11/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 75-5722 KUAKINI HWY STE 212
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City | KAILUA KONA
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State | HI
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Zip | 96740-1708
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Country | US
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Telephone | 808-329-5253
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Fax |
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Provider Business Mailing Address
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Address Line | 75-5722 KUAKINI HWY STE 212
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City | KAILUA KONA
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State | HI
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Zip | 96740-1708
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Country | US
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Telephone | 808-329-5253
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Fax |
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Authorized Official
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Title or Position | DIRECTOR, OPTOMETRIST
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Name | DR. JOHN M TSUE
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Credential | OD
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Telephone | 808-329-5253
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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 | 138D
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License Number State | HI
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