Individual
DR. GLENN MIKIO WATANABE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
94-239 WAIPAHU DEPOT ST, #213, WAIPAHU, HI 96797-3056
(808) 671-2888
(808) 676-1097
Mailing address
94-239 WAIPAHU DEPOT ST, #213, WAIPAHU, HI 96797-3056
(808) 671-2888
(808) 676-1097
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD-151
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04677102
—
HI
Enumeration date
01/28/2007
Last updated
04/11/2008
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