Organization
GRANT Y. FUSATO, OD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRANT FUSATO OD (OWNER)
(808) 486-9393
Entity
Organization
Contact information
Practice address
4510 SALT LAKE BLVD STE B11, HONOLULU, HI 96818-3171
(808) 486-9393
Mailing address
4510 SALT LAKE BLVD STE B11, HONOLULU, HI 96818-3171
(808) 486-9393
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD516
HI
Other
Enumeration date
12/20/2017
Last updated
12/20/2017
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