Provider Demographics
NPI:1558417220
Name:SAKAI, JEFFREY MASARU (OD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:MASARU
Last Name:SAKAI
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 1:2024 N KING ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-3470
Mailing Address - Country:US
Mailing Address - Phone:808-845-4521
Mailing Address - Fax:808-848-0528
Practice Address - Street 1:2024 N KING ST
Practice Address - Street 2:SUITE 105
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-3470
Practice Address - Country:US
Practice Address - Phone:808-845-4521
Practice Address - Fax:808-848-0528
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI473152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00257101Medicaid
HIU68118Medicare UPIN
HIH50527Medicare PIN