Provider Demographics
NPI:1427125822
Name:FUJISAKI, JAMES C (OD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:C
Last Name:FUJISAKI
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 1:94 824 MOLOALO ST
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797
Mailing Address - Country:US
Mailing Address - Phone:808-677-0734
Mailing Address - Fax:808-677-0734
Practice Address - Street 1:94 824 MOLOALO ST
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797
Practice Address - Country:US
Practice Address - Phone:808-677-0734
Practice Address - Fax:808-677-0734
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI337152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0867760002OtherDMERC SUPPLY # 079
HI52619701Medicaid
HI92585OtherHHSA
HI92585OtherHHSA
HI52619701Medicaid