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General NPI Number Information
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NPI Number | 1679613533
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Entity Type | Organization
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Legal Business Name | LEEWARD EYE CARE, INC.
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 94-824 MOLOALO ST
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City | WAIPAHU
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State | HI
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Zip | 96797-3305
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Country | US
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Telephone | 808-677-0734
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Fax |
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Provider Business Mailing Address
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Address Line | 94-824 MOLOALO ST
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City | WAIPAHU
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State | HI
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Zip | 96797-3305
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Country | US
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Telephone | 808-677-0734
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Fax |
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Authorized Official
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Title or Position | VP
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Name | JAMES C FUJISAKI
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Credential | O.D.
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Telephone | 808-677-0734
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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 | 337
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License Number State | HI
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