Individual
DERELYNE KUULANI ROSE GANDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
4414 KUKUI GROVE ST., STE. 101, LIHUE, HI 96766
(808) 632-2020
Mailing address
4414 KUKUI GROVE ST., SUITE 101, LIHUE, HI 96766
(808) 212-6235
(808) 632-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
13180T
CA
152W00000X
Optometrist
Primary
OD674
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
61300102
—
HI
Enumeration date
10/11/2007
Last updated
10/18/2017
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