Provider Demographics
NPI:1184790701
Name:MAUI EYE CARE LLC
Entity type:Organization
Organization Name:MAUI EYE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MY-KHANH
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-250-6261
Mailing Address - Street 1:PO BOX 330321
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96733-0321
Mailing Address - Country:US
Mailing Address - Phone:808-250-6261
Mailing Address - Fax:
Practice Address - Street 1:275 W KAAHUMANU AVE
Practice Address - Street 2:STE. 1010
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-1629
Practice Address - Country:US
Practice Address - Phone:808-877-4766
Practice Address - Fax:808-877-3166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI596152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty