1386819563 NPI number — TIMOTHY E. KALE OPTOMETRIST, INC

Table of content: (NPI 1386819563)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386819563 NPI number — TIMOTHY E. KALE OPTOMETRIST, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TIMOTHY E. KALE OPTOMETRIST, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ALL EYES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386819563
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/28/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
79-7407 MAMALAHOA HWY
Provider Second Line Business Mailing Address:
SUITE E/F
Provider Business Mailing Address City Name:
KEALAKEKUA
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96750-7931
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-322-6100
Provider Business Mailing Address Fax Number:
808-322-6117

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
79-7407 MAMALAHOA HWY
Provider Second Line Business Practice Location Address:
SUITE E/F
Provider Business Practice Location Address City Name:
KEALAKEKUA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96750-7931
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-322-6100
Provider Business Practice Location Address Fax Number:
808-322-6117
Provider Enumeration Date:
04/28/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KALE
Authorized Official First Name:
TIMOTHY
Authorized Official Middle Name:
EDWARD
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
808-322-6100

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  291 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 280621 . This is a "UNIVERSITY HEALTH ALLIANCE" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 197289 . This is a "HMA INC" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: E063825 . This is a "HMSA" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".