Provider Demographics
NPI:1962456046
Name:KAU, MELVIN E (OD)
Entity Type:Individual
Prefix:DR
First Name:MELVIN
Middle Name:E
Last Name:KAU
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 1:91-902 FORT WEAVER RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-2261
Mailing Address - Country:US
Mailing Address - Phone:808-689-8922
Mailing Address - Fax:808-689-3326
Practice Address - Street 1:91-902 FORT WEAVER RD
Practice Address - Street 2:SUITE 206
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-2261
Practice Address - Country:US
Practice Address - Phone:808-689-8922
Practice Address - Fax:808-689-3326
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-21
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI100152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI051325-01Medicaid
HI051325-02Medicaid
HI051325-02Medicaid
HI051325-01Medicaid
HIT41175Medicare UPIN
HIHOOOOPGBSNMedicare ID - Type UnspecifiedHONOLULU OFFICE