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General NPI Number Information
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NPI Number | 1912530395
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Entity Type | Organization
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Legal Business Name | RICHARD H. MIYASAKA OD LLC
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Dates
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Enumeration Date | 02/13/2020
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Last Update Date | 06/06/2020
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Provider Practice Location Address
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Address Line | 3615 HARDING AVE STE 208
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City | HONOLULU
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State | HI
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Zip | 96816-3760
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Country | US
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Telephone | 808-734-8870
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Fax | 808-737-2307
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Provider Business Mailing Address
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Address Line | PO BOX 29690
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City | HONOLULU
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State | HI
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Zip | 96820-2090
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Country | US
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Telephone | 808-677-7727
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Fax | 808-697-5488
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | RICHARD MIYASAKA
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Credential | OD
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Telephone | 808-734-8870
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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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