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General NPI Number Information
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NPI Number | 1720101611
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Entity Type | Organization
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Legal Business Name | WINDWARD VISION CENTER ASSOCIATES, INC.
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Dates
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Enumeration Date | 04/07/2007
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Last Update Date | 01/09/2017
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Provider Practice Location Address
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Address Line | 46-056 KAMEHAMEHA HWY SPC K05
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City | KANEOHE
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State | HI
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Zip | 96744-3768
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Country | US
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Telephone | 808-235-6641
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Fax | 808-247-3880
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Provider Business Mailing Address
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Address Line | 46-056 KAMEHAMEHA HWY SPC K05
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City | KANEOHE
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State | HI
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Zip | 96744-3768
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Country | US
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Telephone | 808-235-6641
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Fax | 808-247-3880
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Authorized Official
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Title or Position | SECOND IN COMMAND
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Name | DR. STUART MACHIDA
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Credential | OD
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Telephone | 808-262-8107
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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 | 184
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 556
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License Number State | HI
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 357
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License Number State | HI
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