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Individual

DR. EDWIN Y ENDO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
98-1247 KAAHUMANU ST, STE 105, AIEA, HI 96701-5300
(808) 487-5500
(808) 486-2694
Mailing address
98-1247 KAAHUMANU ST, STE 105, AIEA, HI 96701-5300
(808) 487-5500
(808) 486-2694

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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