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
Fax: (808) 949-4915
Website:

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639257108 NPPES
Hawaii MEDICAID 02369301

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