Healthcare Provider Details

I. General information

NPI: 1124098900
Provider Name (Legal Business Name): ANN A OHATA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 07/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1319 PUNAHOU ST
HONOLULU HI
96826
US

IV. Provider business mailing address

941 KAMEHAMEHA HWY #208
PEARL CITY HI
96782-2516
US

V. Phone/Fax

Practice location:
  • Phone: 808-983-8626
  • Fax: 808-983-8710
Mailing address:
  • Phone: 808-454-5200
  • Fax: 808-454-5201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number6572
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: