Healthcare Provider Details

I. General information

NPI: 1871244988
Provider Name (Legal Business Name): SIRIMA O'LEARY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2022
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94-1480 MOANIANI ST
WAIPAHU HI
96797-4632
US

IV. Provider business mailing address

94-1480 MOANIANI ST
WAIPAHU HI
96797-4632
US

V. Phone/Fax

Practice location:
  • Phone: 833-833-3333
  • Fax:
Mailing address:
  • Phone: 833-833-3333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA15298
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberAMD-1479
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: