Healthcare Provider Details

I. General information

NPI: 1487913976
Provider Name (Legal Business Name): GREG M OJI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2012
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

931 BUENA VISTA ST STE 302
DUARTE CA
91010-1714
US

IV. Provider business mailing address

931 BUENA VISTA ST STE 302
DUARTE CA
91010-1714
US

V. Phone/Fax

Practice location:
  • Phone: 201-234-9238
  • Fax: 626-358-5572
Mailing address:
  • Phone: 201-234-9238
  • Fax: 626-358-5572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD.207384
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: