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General NPI Number Information
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NPI Number | 1942878137
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Entity Type | Organization
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Legal Business Name | HAWAII VISION PLUS CENTER LLC
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Dates
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Enumeration Date | 06/14/2021
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Last Update Date | 06/14/2021
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Provider Practice Location Address
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Address Line | 302 CALIFORNIA AVE STE 209
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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 | 808-892-3338
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Fax |
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Provider Business Mailing Address
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Address Line | 302 CALIFORNIA AVE STE 209
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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 | 808-892-3338
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KALEEL SHAHEEN II
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Credential | OD
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Telephone | 808-892-3338
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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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