Provider Demographics
NPI:1861250557
Name:SALE, ERICA (LDO)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:SALE
Suffix:
Gender:F
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1038 SPENCER ST APT 302
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-3759
Mailing Address - Country:US
Mailing Address - Phone:808-203-0694
Mailing Address - Fax:808-955-8526
Practice Address - Street 1:700 KEEAUMOKU ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-3014
Practice Address - Country:US
Practice Address - Phone:808-955-8522
Practice Address - Fax:808-955-8526
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDIO-476156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician