Provider Demographics
NPI:1689001430
Name:PAUL S. HIRANO, O.D.
Entity Type:Organization
Organization Name:PAUL S. HIRANO, O.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:S
Authorized Official - Last Name:HIRANO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:310-538-9797
Mailing Address - Street 1:2130 REDONDO BEACH BLVD. #G
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504
Mailing Address - Country:US
Mailing Address - Phone:310-538-9797
Mailing Address - Fax:310-538-1725
Practice Address - Street 1:2130 REDONDO BEACH BLVD. #G
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90504
Practice Address - Country:US
Practice Address - Phone:310-538-9797
Practice Address - Fax:310-538-1725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-10
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0074870Medicaid
CAFT340ZMedicare PIN
CASD0074870Medicaid