MEDICARE: ANNE K. MATSUSHIMA, O.D., INC.

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	332H00000X	Eyewear Supplier	162	HI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0400380001	OTHER	HI	MEDICARE DME

General Provider Information

NPI Number	:	1487851150
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANNE K. MATSUSHIMA, O.D., INC.

Provider Business Mailing Address
First Line	:	3615 HARDING AVE STE 208
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96816-3760
Country	:	US
Telephone Number	:	808-734-8870
Fax Number	:	808-737-2307

Provider Business Practice Location Address
First Line	:	3615 HARDING AVE STE 208
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96816-3760
Country	:	US
Telephone Number	:	808-734-8870
Fax Number	:	808-737-2307

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ANNE K MATSUSHIMA
Credential	:	O.D.
Telephone Number	:	808-734-8870

Provider Enumeration Date	:	06/27/2007
Last Update Date	:	10/14/2010

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Directions to “ANNE K. MATSUSHIMA, O.D., INC. ” Practice Location

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