Provider Demographics
NPI:1598219834
Name:KLAUBA, NICHOLAS I (OD)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:KLAUBA
Suffix:I
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 1:4-901 KUHIO HWY STE B
Mailing Address - Street 2:
Mailing Address - City:KAPAA
Mailing Address - State:HI
Mailing Address - Zip Code:96746-1549
Mailing Address - Country:US
Mailing Address - Phone:808-822-3733
Mailing Address - Fax:808-822-7355
Practice Address - Street 1:4-901 KUHIO HWY STE B
Practice Address - Street 2:
Practice Address - City:KAPAA
Practice Address - State:HI
Practice Address - Zip Code:96746-1549
Practice Address - Country:US
Practice Address - Phone:808-822-3733
Practice Address - Fax:808-822-7355
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-03
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOD865152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist