Provider Demographics
NPI:1811941743
Name:LAI, CHERILYN S L (OD)
Entity type:Individual
Prefix:DR
First Name:CHERILYN
Middle Name:S L
Last Name:LAI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:CHERILYN
Other - Middle Name:S L
Other - Last Name:LAI-KADOOKA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:2827 DOW ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-1134
Mailing Address - Country:US
Mailing Address - Phone:808-595-2162
Mailing Address - Fax:
Practice Address - Street 1:1580 MAKALOA ST
Practice Address - Street 2:SUITE 590
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-3237
Practice Address - Country:US
Practice Address - Phone:808-947-0111
Practice Address - Fax:808-955-2523
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2012-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOD 394152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI04364702Medicaid
HI0000PGBSKMedicare ID - Type Unspecified
HI04364702Medicaid
HI50377Medicare PIN