Provider Demographics
NPI:1194867770
Name:PARADISE OPTICAL CO., INC.
Entity Type:Organization
Organization Name:PARADISE OPTICAL CO., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DARRELL
Authorized Official - Middle Name:JF
Authorized Official - Last Name:CHOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-488-6869
Mailing Address - Street 1:98-1277 KAAHUMANU ST.
Mailing Address - Street 2:#105
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701
Mailing Address - Country:US
Mailing Address - Phone:808-488-6869
Mailing Address - Fax:808-488-6869
Practice Address - Street 1:98-1277 KAAHUMANU ST.
Practice Address - Street 2:#105
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701
Practice Address - Country:US
Practice Address - Phone:808-488-6869
Practice Address - Fax:808-488-6869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIA59681OtherHMSA
HI0000059683OtherHMSA
HI00A0059681OtherHMSA QUEST
HI0000059683OtherHMSA