Provider Demographics
NPI:1326204827
Name:TANOUYE, CHRISTINA PUALANI (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:PUALANI
Last Name:TANOUYE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3085 LOMA VISTA RD
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-2916
Mailing Address - Country:US
Mailing Address - Phone:805-648-3085
Mailing Address - Fax:805-648-7027
Practice Address - Street 1:751 E DAILY DR STE 110
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-6077
Practice Address - Country:US
Practice Address - Phone:805-987-8705
Practice Address - Fax:805-987-7765
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT13547TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist