Tanaka, Glen A
Tanaka, Glen A is an individual health care provider with primary practice located at 1831 S King St Ste 203 , Honolulu HI 96826-2131. He recently has 4 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Low Vision Rehabilitation, Eye and Vision Services Providers / Pediatrics. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Tanaka, Glen A can be contacted via phone (808) 955-2015.Contact Information
Primary practice address
1831 S King St Ste 203
Honolulu HI 96826-2131
Phone: (808) 955-2015
Fax: (808) 949-4915
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Eye and Vision Services Providers / Optometrist | 152W00000X | 279 | Hawaii |
Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 279 | Hawaii |
Eye and Vision Services Providers / Low Vision Rehabilitation | 152WL0500X | 279 | Hawaii |
Eye and Vision Services Providers / Pediatrics | 152WP0200X | 279 | Hawaii |
Profile Details
NPI number | 1639257108 |
---|---|
LBN Legal business name | Tanaka, Glen A |
Credentials | Doctor of Optometry (OD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Nov 1st, 2006 |
Last updated | Jul 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1639257108 | NPPES |
Hawaii | MEDICAID | 02369301 |
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