Provider Demographics
NPI:1134450182
Name:HAWAIIAN EYE CENTER, INC.
Entity type:Organization
Organization Name:HAWAIIAN EYE CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CEO, MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:M
Authorized Official - Last Name:TORTORA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-621-8448
Mailing Address - Street 1:1178 KINOOLE ST STE A
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-7206
Mailing Address - Country:US
Mailing Address - Phone:808-969-1419
Mailing Address - Fax:808-969-1297
Practice Address - Street 1:1178 KINOOLE ST STE A
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-7206
Practice Address - Country:US
Practice Address - Phone:808-969-1419
Practice Address - Fax:808-969-1297
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HAWAIIAN EYE CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-01-14
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1580152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00S0023776OtherHMSA (BCBS, HI) OPT PIN-HILO
HI01483801Medicaid
HI0527150007Medicare NSC
HIW19788Medicare UPIN