Provider Demographics
NPI:1073975843
Name:ENDO, EDWIN YOSHIO II (OD)
Entity Type:Individual
Prefix:MR
First Name:EDWIN
Middle Name:YOSHIO
Last Name:ENDO
Suffix:II
Gender:M
Credentials:OD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:98-1247 KAAHUMANU ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701
Mailing Address - Country:US
Mailing Address - Phone:808-487-5500
Mailing Address - Fax:808-488-2322
Practice Address - Street 1:98-1247 KAAHUMANU ST
Practice Address - Street 2:SUITE 105
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701
Practice Address - Country:US
Practice Address - Phone:808-487-5500
Practice Address - Fax:808-488-2322
Is Sole Proprietor?:No
Enumeration Date:2016-03-22
Last Update Date:2016-08-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HI833152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI833OtherHAWAII STATE LICENSE
HIH108538OtherMEDICARE ID