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General NPI Number Information
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NPI Number | 1700011996
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Entity Type | Organization
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Legal Business Name | FAMILY EYE CARE ASSOCIATES-KAPOLEI, LLC.
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Dates
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Enumeration Date | 05/18/2009
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Last Update Date | 02/03/2010
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Provider Practice Location Address
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Address Line | 1001 KAMOKILA BLVD # 108 JAMES CAMPBELL BLDG.
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City | KAPOLEI
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State | HI
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Zip | 96707-2014
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Country | US
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Telephone | 808-674-0085
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Fax | 808-674-8785
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Provider Business Mailing Address
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Address Line | 1001 KAMOKILA BLVD # 108 JAMES CAMPBELL BLDG.
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City | KAPOLEI
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State | HI
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Zip | 96707-2014
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Country | US
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Telephone | 808-674-0085
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Fax | 808-674-8785
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | DR. TODD KYLE NAKAGAWA
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Credential | O.D.
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Telephone | 808-674-0085
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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 | 572
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License Number State | HI
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