Provider Demographics
NPI:1679566343
Name:FUJINAKA, MILES S (OD)
Entity Type:Individual
Prefix:
First Name:MILES
Middle Name:S
Last Name:FUJINAKA
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 1:98-211 PALI MOMI ST
Mailing Address - Street 2:STE 803
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4340
Mailing Address - Country:US
Mailing Address - Phone:808-487-7997
Mailing Address - Fax:808-487-7166
Practice Address - Street 1:98-211 PALI MOMI ST
Practice Address - Street 2:STE 803
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4340
Practice Address - Country:US
Practice Address - Phone:808-487-7997
Practice Address - Fax:808-487-7166
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-26
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOD126152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI58958OtherHMSA
HI199090OtherHMA
HI05160001Medicaid
HI58958OtherHMSA
HIT41147Medicare UPIN
HI05160001Medicaid