Provider Demographics
NPI:1821147620
Name:LIN, PEILI (OD)
Entity Type:Individual
Prefix:DR
First Name:PEILI
Middle Name:
Last Name:LIN
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 1:377 KEAHOLE ST
Mailing Address - Street 2:STE A14
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-3427
Mailing Address - Country:US
Mailing Address - Phone:808-593-2377
Mailing Address - Fax:808-593-1447
Practice Address - Street 1:615 PIIKOI ST STE 1510
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-3142
Practice Address - Country:US
Practice Address - Phone:808-593-2377
Practice Address - Fax:808-593-1447
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI498152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIU72094Medicare UPIN
53282Medicare ID - Type Unspecified