Provider Demographics
NPI:1700322294
Name:CARLA WATASE
Entity type:Organization
Organization Name:CARLA WATASE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:WATASE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:808-728-1189
Mailing Address - Street 1:1123 11TH AVE
Mailing Address - Street 2:STE 203
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-2433
Mailing Address - Country:US
Mailing Address - Phone:808-734-7050
Mailing Address - Fax:
Practice Address - Street 1:1123 11TH AVE
Practice Address - Street 2:STE 203
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-2433
Practice Address - Country:US
Practice Address - Phone:808-734-7050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NELSON O. YOSHIOKA JR., O.D., INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-01-09
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOD853152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty