Healthcare Provider Details

I. General information

NPI: 1235200718
Provider Name (Legal Business Name): ODA OHANA CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1481 S KING ST STE 438
HONOLULU HI
96814-2605
US

IV. Provider business mailing address

1481 S KING ST STE 438
HONOLULU HI
96814-2605
US

V. Phone/Fax

Practice location:
  • Phone: 808-942-2232
  • Fax: 808-942-2234
Mailing address:
  • Phone: 808-942-2232
  • Fax: 808-942-2234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number1066
License Number StateHI

VIII. Authorized Official

Name: DR. PARIS ODA
Title or Position: PRESIDENT
Credential: D.C.
Phone: 808-942-2232