Provider Demographics
NPI:1740658848
Name:808 EYE CARE, LLC
Entity type:Organization
Organization Name:808 EYE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:OTOMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-854-5773
Mailing Address - Street 1:PO BOX 240726
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96824-0726
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:55 S KUKUI ST
Practice Address - Street 2:SUITE C109
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2310
Practice Address - Country:US
Practice Address - Phone:808-531-8874
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-04
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty