Provider Demographics
NPI:1033291968
Name:ALONZO, CALVIN (OD)
Entity Type:Individual
Prefix:DR
First Name:CALVIN
Middle Name:
Last Name:ALONZO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 N KUAKINI ST
Mailing Address - Street 2:STE 605
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-6302
Mailing Address - Country:US
Mailing Address - Phone:808-677-7222
Mailing Address - Fax:808-677-3300
Practice Address - Street 1:405 N KUAKINI ST
Practice Address - Street 2:STE 605
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-6302
Practice Address - Country:US
Practice Address - Phone:808-847-7222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOD573152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI52648601Medicaid
HI4760220001Medicare NSC
HI52648601Medicaid
HIU91759Medicare UPIN