MEDICARE: DR. KEN NAGAHIRO

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	105	HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5873-5	OTHER	HI	HMSA
2	5873-5	OTHER	HI	TRICARE
3	5873-5	OTHER	HI	ALOHA CARE QUEST
4	0000058735	OTHER	HI	HMSA QUEST
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	5873-5	OTHER	HI	HMAA
7	5873-5	OTHER	HI	HMA
8	5873-5	OTHER	HI	SUMMERLIN LIFE AND HEALTH

General Provider Information

NPI Number	:	1598717902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEN NAGAHIRO

Provider Business Mailing Address
First Line	:	91-803 PAPIPI RD
Second Line	:
City	:	EWA BEACH
State	:	HI
Zip	:	96706-2438
Country	:	US
Telephone Number	:	808-689-7911
Fax Number	:	808-689-8831

Provider Business Practice Location Address
First Line	:	91-803 PAPIPI RD
Second Line	:
City	:	EWA BEACH
State	:	HI
Zip	:	96706-2438
Country	:	US
Telephone Number	:	808-689-7911
Fax Number	:	808-689-8831

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	12/17/2008

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Directions to “ DR. KEN NAGAHIRO ” Practice Location

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