Provider Demographics
NPI:1497186993
Name:ROLIN OTOMO, O.D.
Entity Type:Organization
Organization Name:ROLIN OTOMO, O.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:OTOMO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:808-854-5773
Mailing Address - Street 1:808 AHUA ST
Mailing Address - Street 2:MB#38
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-2029
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:55 S KUKUI ST
Practice Address - Street 2:SUITE C-109
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2310
Practice Address - Country:US
Practice Address - Phone:808-638-0466
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-09
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty