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General NPI Number Information
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NPI Number | 1679626360
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Entity Type | Individual
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Provider Name | RODNEY S.O. FONG O.D.
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Gender | Male
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 01/28/2011
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Provider Practice Location Address
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Address Line | 725 KAPIOLANI BLVD STE C204
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City | HONOLULU
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State | HI
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Zip | 96813-6023
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Country | US
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Telephone | 808-593-8939
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Fax | 808-593-8307
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Provider Business Mailing Address
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Address Line | 725 KAPIOLANI BLVD STE C204
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City | HONOLULU
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State | HI
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Zip | 96813-6023
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Country | US
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Telephone | 808-593-8939
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Fax | 808-593-8307
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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 | 187D
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License Number State | HI
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