Provider Demographics
NPI:1689630535
Name:KAWASAKI, BRIAN S (OD, MBA)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:S
Last Name:KAWASAKI
Suffix:
Gender:M
Credentials:OD, MBA
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Mailing Address - Street 1:6900 NORTH PECOS ROAD
Mailing Address - Street 2:VA SOUTHERN NEVADA HEALTHCARE SYSTEM
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89086-4400
Mailing Address - Country:US
Mailing Address - Phone:702-791-9125
Mailing Address - Fax:702-791-9376
Practice Address - Street 1:6900 NORTH PECOS ROAD
Practice Address - Street 2:VA SOUTHERN NEVADA HEALTHCARE SYSTEM
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89086-4400
Practice Address - Country:US
Practice Address - Phone:702-791-9125
Practice Address - Fax:702-791-9376
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA11364152W00000X
NV614152W00000X
OK2566152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist