Provider Demographics
NPI:1295809101
Name:MACHIDA, STUART K (OD)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:K
Last Name:MACHIDA
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 1:30 AULIKE ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-2707
Mailing Address - Country:US
Mailing Address - Phone:808-262-8107
Mailing Address - Fax:808-262-8108
Practice Address - Street 1:30 AULIKE ST
Practice Address - Street 2:SUITE 102
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2707
Practice Address - Country:US
Practice Address - Phone:808-262-8107
Practice Address - Fax:808-262-8108
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI357152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00962401Medicaid
HI0824380001Medicare NSC
HIBY570ZMedicare PIN
HIH0000PGBLVMedicare PIN
HIBY562AMedicare PIN
HIH0000PGBMSMedicare PIN
HIBY570YMedicare PIN
HIBY562BMedicare PIN
HIU40616Medicare UPIN