MEDICARE: SPECS UNLIMITED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	120	HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0000228460	OTHER	HI	HMSA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184796120
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPECS UNLIMITED

Provider Business Mailing Address
First Line	:	850 W HIND DR
Second Line	:	SUITE 100
City	:	HONOLULU
State	:	HI
Zip	:	96821-1855
Country	:	US
Telephone Number	:	808-377-3539
Fax Number	:	808-377-5030

Provider Business Practice Location Address
First Line	:	850 W HIND DR
Second Line	:	SUITE 100
City	:	HONOLULU
State	:	HI
Zip	:	96821-1855
Country	:	US
Telephone Number	:	808-377-3539
Fax Number	:	808-377-5030

Authorized Official
Title or Position	:	PARTNER
Name	:	DR. CHARLES DEAN
Credential	:	O.D.
Telephone Number	:	808-377-3539

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	08/22/2020

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Directions to “SPECS UNLIMITED ” Practice Location

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