Organization
ALOHA EYE CLINIC, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIVIN TANTISIRA MD (PRESIDENT)
(808) 877-3984
Entity
Organization
Contact information
Practice address
450 HOOKAHI ST, WAILUKU, HI 96793-1474
(808) 877-3984
(808) 871-6498
Mailing address
PO BOX 29960, HONOLULU, HI 96820-2360
(801) 845-2677
(808) 871-6498
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OD-809
HI
207W00000X
Ophthalmology Physician
Primary
MD-9427
HI
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
MD-9427
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00264901
—
HI
Enumeration date
06/03/2006
Last updated
04/29/2025
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