Provider Demographics
NPI:1013047307
Name:FERNANDEZ, LORENE CHAI (OD)
Entity type:Individual
Prefix:DR
First Name:LORENE
Middle Name:CHAI
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:LORENE
Other - Middle Name:VANESSA
Other - Last Name:CHAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:540 HALEAKALA HWY
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-2302
Mailing Address - Country:US
Mailing Address - Phone:808-871-8545
Mailing Address - Fax:
Practice Address - Street 1:24 KIOPAA PL STE 102
Practice Address - Street 2:
Practice Address - City:MAKAWAO
Practice Address - State:HI
Practice Address - Zip Code:96768-8295
Practice Address - Country:US
Practice Address - Phone:808-214-9074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOD-342152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist