Provider Demographics
NPI:1063586741
Name:PUNZAL, JOEL ERNEST (OD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:ERNEST
Last Name:PUNZAL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4454 NUHOU ST STE 513
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-8022
Mailing Address - Country:US
Mailing Address - Phone:088-278-8383
Mailing Address - Fax:808-855-2004
Practice Address - Street 1:4454 NUHOU ST
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-8022
Practice Address - Country:US
Practice Address - Phone:808-278-8383
Practice Address - Fax:808-855-2004
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI607152WC0802X
HIOD-607152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI547903-01Medicaid
HI547903-01Medicaid
HIU98719Medicare UPIN