Vision Source Kailua- LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

135 Issued in HI

Legal business name

VISION SOURCE KAILUA- LLC

Practice address

45 Aulike St
Suite 47
Kailua, HI 96734-2708

Phone

(808) 262-2330

Fax

(808) 261-5423

NPI assigned

Mar 13, 2007

Last updated

Apr 6, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Donna Jean Soares, O

Title

Office Manager

Phone

(808) 262-2330

Specialties & licenses 1

Addresses

Other names 1

• Dr. Guy M Nishizawa, O.D. Former legal business name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270512000000",
    "number": "1023141546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 AULIKE ST",
            "address_2": "SUITE 47",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967342708",
            "telephone_number": "808-262-2330",
            "fax_number": "808-261-5423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 AULIKE ST",
            "address_2": "SUITE 47",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967342708",
            "telephone_number": "808-262-2330",
            "fax_number": "808-261-5423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION SOURCE KAILUA- LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2010-04-06",
        "status": "A",
        "authorized_official_last_name": "SOARES",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "808-262-2330",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "O"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "HI",
            "license": "135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Guy M Nishizawa, O.D.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Optometrist in Kailua, HI
• Providers in Kailua, HI by specialty
• Optometrist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.