Individual
ZACK ZIMMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1619 LUSITANA ST, HONOLULU, HI 96813-6621
(808) 295-7311
Mailing address
PO BOX 23273, HONOLULU, HI 96823-3273
(808) 295-7311
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DIO-397
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W73879484-01
STATE TAX ID
HI
Enumeration date
05/18/2014
Last updated
05/18/2014
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