Provider Demographics
NPI:1992470421
Name:DR. MIYASAKA OPTOMETRY, LLC
Entity Type:Organization
Organization Name:DR. MIYASAKA OPTOMETRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/BUSINESS OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:K
Authorized Official - Last Name:MIYASAKA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:808-782-8546
Mailing Address - Street 1:3615 HARDING AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-3760
Mailing Address - Country:US
Mailing Address - Phone:808-782-8546
Mailing Address - Fax:808-737-2307
Practice Address - Street 1:3615 HARDING AVE STE 208
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-3760
Practice Address - Country:US
Practice Address - Phone:808-782-8546
Practice Address - Fax:808-737-2307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty