1730216938 NPI number — NELSON O YOSHIOKA JR OD INC

Table of content: (NPI 1730216938)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730216938 NPI number — NELSON O YOSHIOKA JR OD INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NELSON O YOSHIOKA JR OD 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:
CHERYL NIITANI OD
Provider Other Organization Name Type Code:
5
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:
1730216938
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/04/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1123 11TH AVE
Provider Second Line Business Mailing Address:
#203
Provider Business Mailing Address City Name:
HONOLULU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96816-2433
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-734-7050
Provider Business Mailing Address Fax Number:
808-734-8897

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1123 11TH AVE
Provider Second Line Business Practice Location Address:
#203
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96816-2433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-734-7050
Provider Business Practice Location Address Fax Number:
808-734-8897
Provider Enumeration Date:
02/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
YOSHIOKA
Authorized Official First Name:
NELSON
Authorized Official Middle Name:
O
Authorized Official Title or Position:
DR
Authorized Official Telephone Number:
808-734-7050

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  OD219 , 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: C21513 . This is a "HMSA - KAIMUKI" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 57674230121 . This is a "UHA - VISION" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: J21517 . This is a "HMSA - PC" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 57674230101 . This is a "UHA - MEDICAL" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".




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