Provider Demographics
NPI:1780804153
Name:DR. MICHAEL VANLANGEVELD AND ASSOCIATES
Entity type:Organization
Organization Name:DR. MICHAEL VANLANGEVELD AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OTOMETRIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VANLANGEVELD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:808-591-6601
Mailing Address - Street 1:1050 ALA MOANA BLVD STE1325
Mailing Address - Street 2:WARD WAREHOUSE
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4979
Mailing Address - Country:US
Mailing Address - Phone:808-591-6601
Mailing Address - Fax:808-591-0137
Practice Address - Street 1:1050 ALA MOANA BLVD STE A8
Practice Address - Street 2:WARD WAREHOUSE
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4979
Practice Address - Country:US
Practice Address - Phone:808-591-6601
Practice Address - Fax:808-591-0137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI401152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI526109OtherSUMMERLIN
HI56655639122OtherUHA
HI0000202663OtherHMSA
HI0000202663OtherHMSA QUEST