Provider Demographics
NPI:1487851150
Name:ANNE K. MATSUSHIMA, O.D., INC.
Entity Type:Organization
Organization Name:ANNE K. MATSUSHIMA, O.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:K
Authorized Official - Last Name:MATSUSHIMA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:808-734-8870
Mailing Address - Street 1:3615 HARDING AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-3760
Mailing Address - Country:US
Mailing Address - Phone:808-734-8870
Mailing Address - Fax:808-737-2307
Practice Address - Street 1:3615 HARDING AVE STE 208
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-3760
Practice Address - Country:US
Practice Address - Phone:808-734-8870
Practice Address - Fax:808-737-2307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI162332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0400380001OtherMEDICARE DME
HI0400380001OtherMEDICARE DME