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General NPI Number Information
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NPI Number | 1750013371
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Entity Type | Organization
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Legal Business Name | OUT TO SEE
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Dates
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Enumeration Date | 06/30/2022
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Last Update Date | 02/01/2023
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Provider Practice Location Address
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Address Line | 573 KAILUA RD STE 106
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City | KAILUA
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State | HI
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Zip | 96734-2836
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Country | US
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Telephone | 808-501-2020
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Fax | 808-501-2015
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Provider Business Mailing Address
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Address Line | 356 ONEAWA ST
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City | KAILUA
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State | HI
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Zip | 96734-2400
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | LAUREN MORDUE
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Credential | OD
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Telephone | 808-501-2020
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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 |
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License Number State |
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