Provider Demographics
NPI:1396731717
Name:MATSUSHIMA, ANNE K (OD)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:K
Last Name:MATSUSHIMA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3615 HARDING AVE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-3760
Mailing Address - Country:US
Mailing Address - Phone:808-734-8870
Mailing Address - Fax:808-737-2307
Practice Address - Street 1:3615 HARDING AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-3760
Practice Address - Country:US
Practice Address - Phone:808-734-8870
Practice Address - Fax:808-737-2307
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI162152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIA0276-4OtherHMSA
HIT41213Medicare UPIN
HI0000PGBFPMedicare PIN