Provider Demographics
NPI:1740252337
Name:FUKAI AND ASSOCIATES PC
Entity type:Organization
Organization Name:FUKAI AND ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:FUKAI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:303-666-7226
Mailing Address - Street 1:1371 HECLA DR
Mailing Address - Street 2:STE C
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-2318
Mailing Address - Country:US
Mailing Address - Phone:303-666-7226
Mailing Address - Fax:303-665-3367
Practice Address - Street 1:1371 HECLA DR
Practice Address - Street 2:STE C
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-2318
Practice Address - Country:US
Practice Address - Phone:303-666-7226
Practice Address - Fax:303-665-3367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-07
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COF1603Medicare ID - Type Unspecified