Provider Demographics
NPI:1750307088
Name:GUSHIKEN, CLAYTON YOICHI (OD)
Entity Type:Individual
Prefix:DR
First Name:CLAYTON
Middle Name:YOICHI
Last Name:GUSHIKEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2353 S BERETANIA ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-1400
Mailing Address - Country:US
Mailing Address - Phone:808-941-3811
Mailing Address - Fax:808-951-4063
Practice Address - Street 1:2353 S BERETANIA ST
Practice Address - Street 2:SUITE 101
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1400
Practice Address - Country:US
Practice Address - Phone:808-941-3811
Practice Address - Fax:808-951-4063
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIO.D.-179152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WV0400XEye and Vision Services ProvidersOptometristVision Therapy