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NPI Code Detail

MEDICARE: VALERIE SACHIKO KITAMORI OD

MEDICARE: VALERIE SACHIKO KITAMORI OD
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
1152W00000XOptometrist33362CA
2152W00000XOptometristOD60574434WA
3152W00000XOptometristOD-830HI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1OD-830OTHERHIMEDICAL LICENSE

General Provider Information

NPI Number : 1548512874
Entity Type Code : Individual
Provider Name (Legal Business Name) : VALERIE SACHIKO KITAMORI OD
Provider Business Mailing Address
First Line : 15645 AVENIDA ALCACHOFA APT D
Second Line :
City : SAN DIEGO
State : CA
Zip : 92128-4442
Country : US
Telephone Number : 808-896-6214
Fax Number :
Provider Business Practice Location Address
First Line : 73-5600 MAIAU ST
Second Line :
City : KAILUA KONA
State : HI
Zip : 96740-2630
Country : US
Telephone Number : 808-331-8081
Fax Number : 808-331-8082
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2012
Last Update Date : 08/21/2020

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Directions to “ VALERIE SACHIKO KITAMORI OD” Practice Location

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