Provider Demographics
NPI:1417601956
Name:J C EYE, LLC
Entity Type:Organization
Organization Name:J C EYE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:IIDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-456-1527
Mailing Address - Street 1:1212 NUUANU AVE APT 4011
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-4042
Mailing Address - Country:US
Mailing Address - Phone:626-456-1527
Mailing Address - Fax:
Practice Address - Street 1:1109 12TH AVE STE 103
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-3714
Practice Address - Country:US
Practice Address - Phone:808-734-1988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-03
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty