Individual
DR. GRANT Y. FUSATO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4510 SALT LAKE BLVD, B-11, HONOLULU, HI 96818-3153
(808) 486-9393
(808) 486-9391
Mailing address
4510 SALT LAKE BLVD, B-11, HONOLULU, HI 96818-3153
(808) 486-9393
(808) 486-9391
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD516
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
990348300
TRICARE
HI
01
—
A21764-4
HMSA
HI
Enumeration date
12/28/2005
Last updated
12/19/2017
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