Individual
DR. EDWIN Y ENDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
149
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000PCBQF
MEDICARE INDIVIDUAL
HI
05
—
04604501
—
HI
01
—
HEENDO
MEDICARE GROUP PTAN
HI
Enumeration date
01/10/2006
Last updated
06/03/2012
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