Provider Demographics
NPI:1639509987
Name:MIYASAKA, JAMES KIYOSHI (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:KIYOSHI
Last Name:MIYASAKA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3615 HARDING AVE
Mailing Address - Street 2:STE 208
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
Practice Address - Street 2:STE 208
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
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-23
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA14802152W00000X
HI785152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist