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General NPI Number Information
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NPI Number | 1851780621
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Entity Type | Organization
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Legal Business Name | KAWAMURA EYE CARE, LLC
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Dates
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Enumeration Date | 01/17/2015
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Last Update Date | 01/17/2015
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Provider Practice Location Address
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Address Line | 302 CALIFORNIA AVE SUITE 102
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City | WAHIAWA
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State | HI
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Zip | 96786-1841
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Country | US
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Telephone | 808-621-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 94-761 MEAHALE ST
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City | WAIPAHU
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State | HI
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Zip | 96797-4025
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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 | MANAGER
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Name | DR. KEITH T KAWAMURA
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Credential | O.D.
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Telephone | 808-497-2589
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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 | 535
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License Number State | HI
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