Healthcare Provider Details

I. General information

NPI: 1821793464
Provider Name (Legal Business Name): KEVIN TIMOTHY O'HARA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2023
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 KAPIOLANI BLVD STE 705
HONOLULU HI
96813-5241
US

IV. Provider business mailing address

770 KAPIOLANI BLVD STE 705
HONOLULU HI
96813-5241
US

V. Phone/Fax

Practice location:
  • Phone: 808-597-8778
  • Fax:
Mailing address:
  • Phone: 808-597-8778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD-26775
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: