Provider Demographics
NPI:1104209253
Name:ALAN Y. TANAKA, O.D., LLC
Entity Type:Organization
Organization Name:ALAN Y. TANAKA, O.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:Y
Authorized Official - Last Name:TANAKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-732-1566
Mailing Address - Street 1:PO BOX 22998
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96823-2998
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:98-1256 KAAHUMANU ST
Practice Address - Street 2:STE E101
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-3282
Practice Address - Country:US
Practice Address - Phone:808-732-1566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-08
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOD629152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty