Provider Demographics
NPI:1205884418
Name:SAKUDA, JON MITSURU (OD)
Entity type:Individual
Prefix:DR
First Name:JON
Middle Name:MITSURU
Last Name:SAKUDA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:459 PATTERSON RD
Mailing Address - Street 2:HONOLULU VAMC
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-1522
Mailing Address - Country:US
Mailing Address - Phone:808-433-7642
Mailing Address - Fax:808-433-7744
Practice Address - Street 1:459 PATTERSON RD
Practice Address - Street 2:HONOLULU VAMC
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-1522
Practice Address - Country:US
Practice Address - Phone:808-433-7642
Practice Address - Fax:808-433-7744
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOD290152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist