Provider Demographics
NPI:1447215082
Name:KAJIWARA, EDWIN SHINJI (OD)
Entity type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:SHINJI
Last Name:KAJIWARA
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 1:1520 LILIHA ST
Mailing Address - Street 2:STE 401
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-3562
Mailing Address - Country:US
Mailing Address - Phone:808-531-6331
Mailing Address - Fax:808-531-6331
Practice Address - Street 1:1520 LILIHA ST
Practice Address - Street 2:STE 401
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-3562
Practice Address - Country:US
Practice Address - Phone:808-531-6331
Practice Address - Fax:808-531-6331
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI174152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI01208801Medicaid
HI12690OtherHMSA
HI12690OtherHMSA
HI0000PGBFCMedicare ID - Type Unspecified