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General NPI Number Information
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NPI Number | 1669781704
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Entity Type | Individual
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Provider Name | SARA ELLEN MISAKO TOYOTA O.D.
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Gender | Female
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Dates
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Enumeration Date | 10/06/2010
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Last Update Date | 01/06/2011
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Provider Practice Location Address
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Address Line | 46-056 KAMEHAMEHA HWY #1-6
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City | KANEOHE
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State | HI
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Zip | 96744-3755
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Country | US
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Telephone | 808-235-6641
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Fax |
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Provider Business Mailing Address
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Address Line | 46-056 KAMEHAMEHA HWY # 1-6
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City | KANEOHE
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State | HI
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Zip | 96744-3755
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Country | US
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Telephone | 808-235-1838
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | OD 732
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License Number State | HI
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