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47 Lanihuli Street, Hilo, HI 96720-4142 | |
(808) 961-4711 | |
(808) 969-3343 |
Full Name | |
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Type | Facility |
Speciality | Ophthalmology |
Location | 47 Lanihuli Street, Hilo, Hawaii |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1306998117 | NPI | - | NPPES |
52128801 | Medicaid | HI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | OD519 (Hawaii) | Secondary |
207W00000X | Ophthalmology | 10320 (Hawaii) | Primary |
Provider Name | Michael Miyashiro |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1699868844 PECOS PAC ID: 9133018930 Enrollment ID: I20061010000735 |
Provider Name | Carlos A Gonzales |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1306831060 PECOS PAC ID: 4082500202 Enrollment ID: I20131029000129 |
Provider Name | Rachel E.k. Slater |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1558614370 PECOS PAC ID: 5890081731 Enrollment ID: I20160901001542 |
Mailing Address | Practice Location Address |
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47 Lanihuli Street, Hilo, HI 96720-4142 Ph: (808) 961-4711 | 47 Lanihuli Street, Hilo, HI 96720-4142 Ph: (808) 961-4711 |