Healthcare Provider Details

I. General information

NPI: 1477655116
Provider Name (Legal Business Name): SHOZO OGAWA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 09/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2065 S KING ST STE 201
HONOLULU HI
96826-2225
US

IV. Provider business mailing address

1441 KAPIOLANI BLVD, #2000
HONOLULU HI
96814
US

V. Phone/Fax

Practice location:
  • Phone: 808-941-3766
  • Fax: 808-942-2775
Mailing address:
  • Phone: 808-945-3719
  • Fax: 808-945-3629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD2014
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: