Provider Demographics
NPI:1083133045
Name:MIKI, MAILE N (OD)
Entity Type:Individual
Prefix:DR
First Name:MAILE
Middle Name:N
Last Name:MIKI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 NUUANU AVE APT 2110
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-4028
Mailing Address - Country:US
Mailing Address - Phone:808-285-1325
Mailing Address - Fax:
Practice Address - Street 1:95-550 LANIKUHANA AVE
Practice Address - Street 2:
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-1783
Practice Address - Country:US
Practice Address - Phone:808-623-0702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-11
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI866152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist