Provider Demographics
NPI:1295851244
Name:JAN L. HIRAKAWA,O.D., INC
Entity Type:Organization
Organization Name:JAN L. HIRAKAWA,O.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:HIRAKAWA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:808-949-9999
Mailing Address - Street 1:1820 ALGAROBA ST STE 200
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-2678
Mailing Address - Country:US
Mailing Address - Phone:808-949-9999
Mailing Address - Fax:808-949-5769
Practice Address - Street 1:1820 ALGAROBA ST STE 200
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-2678
Practice Address - Country:US
Practice Address - Phone:808-949-9999
Practice Address - Fax:808-949-5769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI168152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIGROUP PIN 100278Medicare ID - Type Unspecified