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General NPI Number Information
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NPI Number | 1972994341
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Entity Type | Organization
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Legal Business Name | KHAN LAU OPTOMETRIST INC.
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Dates
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Enumeration Date | 02/06/2015
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Last Update Date | 02/06/2015
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Provider Practice Location Address
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Address Line | 737 BISHOP ST SUITE 110
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City | HONOLULU
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State | HI
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Zip | 96813-3201
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Country | US
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Telephone | 808-523-6484
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Fax | 808-523-6485
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Provider Business Mailing Address
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Address Line | 98-1256 KAAHUMANU ST # E-101
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City | PEARL CITY
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State | HI
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Zip | 96782-3282
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Country | US
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Telephone | 808-380-4379
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Fax | 808-735-5595
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Authorized Official
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Title or Position | PRESIDENT
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Name | KHAN LAU
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Credential |
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Telephone | 808-523-6484
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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 | HI309
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License Number State | HI
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