Provider Demographics
NPI:1336171131
Name:SAKAMOTO, RANDALL (OD, PHD)
Entity Type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:
Last Name:SAKAMOTO
Suffix:
Gender:M
Credentials:OD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 KAPIOLANI BLVD STE 2005
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4408
Mailing Address - Country:US
Mailing Address - Phone:808-944-9911
Mailing Address - Fax:808-944-9913
Practice Address - Street 1:1441 KAPIOLANI BLVD STE 2005
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4408
Practice Address - Country:US
Practice Address - Phone:808-944-9911
Practice Address - Fax:808-944-9913
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOD-186152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI59720501Medicaid
HI102647Medicare PIN