Provider Demographics
NPI:1508920307
Name:ONIZUKA, HOMER J (OD)
Entity Type:Individual
Prefix:DR
First Name:HOMER
Middle Name:J
Last Name:ONIZUKA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 HAMAKUA DR
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-3984
Mailing Address - Country:US
Mailing Address - Phone:808-432-3400
Mailing Address - Fax:
Practice Address - Street 1:201 HAMAKUA DR
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-3984
Practice Address - Country:US
Practice Address - Phone:808-432-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOD-166152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI011065-02Medicaid
HIT41244Medicare UPIN
HIH55908Medicare PIN