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General NPI Number Information
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NPI Number | 1609219112
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Entity Type | Individual
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Provider Name | EMI OTA M.D., PH.D.
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Gender | Female
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Dates
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Enumeration Date | 04/15/2013
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Last Update Date | 08/29/2016
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Provider Practice Location Address
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Address Line | 2250 KALAKAUA AVE STE 407
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City | HONOLULU
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State | HI
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Zip | 96815-2546
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Country | US
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Telephone | 808-367-0513
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Fax | 808-367-0514
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Provider Business Mailing Address
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Address Line | 2250 KALAKAUA AVE STE 407
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City | HONOLULU
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State | HI
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Zip | 96815-2546
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Country | US
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Telephone | 808-367-0513
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Fax | 808-367-0514
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MDR-6474
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License Number State | HI
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 18532
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License Number State | HI
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