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General NPI Number Information
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NPI Number | 1871707513
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Entity Type | Individual
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Provider Name | CORNELIUS JOSEPH O'LEARY JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 09/11/2023
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Provider Practice Location Address
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Address Line | 888 S KING ST
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City | HONOLULU
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State | HI
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Zip | 96813-3097
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Country | US
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Telephone | 702-720-5420
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Fax |
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Provider Business Mailing Address
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Address Line | FEMA MONOCLONAL ANTIBODY UNIT 888 S KING ST
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City | HONOLULU
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State | HI
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Zip | 96813
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Country | US
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Telephone | 702-720-5420
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Fax | 702-720-5420
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 160284
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License Number State | CA
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