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General NPI Number Information
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NPI Number | 1073881009
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Entity Type | Organization
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Legal Business Name | RICHARD S OH MD LLC
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Dates
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Enumeration Date | 12/05/2011
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Last Update Date | 12/05/2011
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Provider Practice Location Address
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Address Line | 91-2139 FORT WEAVER RD SUITE 309
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City | EWA BEACH
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State | HI
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Zip | 96706-3607
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Country | US
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Telephone | 808-677-7793
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Fax | 808-677-7868
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Provider Business Mailing Address
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Address Line | 91-2139 FORT WEAVER RD SUITE 309
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City | EWA BEACH
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State | HI
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Zip | 96706-3607
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Country | US
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Telephone | 808-677-7793
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Fax | 808-677-7868
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Authorized Official
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Title or Position | OWNER
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Name | DR. RICHARD S OH
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Credential | M,D.
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Telephone | 808-677-7793
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | MD7689
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License Number State | HI
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