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NPI Code Detail

MEDICARE: OAHU IMAGING LLC

MEDICARE: OAHU IMAGING LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207U00000XNuclear Medicine PhysicianMD-7517HI

General Provider Information

NPI Number : 1548299811
Entity Type Code : Organization
Provider Name (Legal Business Name) : OAHU IMAGING LLC
Provider Business Mailing Address
First Line : PO BOX 971135
Second Line :
City : WAIPAHU
State : HI
Zip : 96797-8135
Country : US
Telephone Number : 808-447-9218
Fax Number :
Provider Business Practice Location Address
First Line : 91-2141 FORT WEAVER RD
Second Line :
City : EWA BEACH
State : HI
Zip : 96706-1993
Country : US
Telephone Number : 808-691-3000
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. SHAY J LEE
Credential : M.D.
Telephone Number : 808-447-9218
Provider Enumeration Date : 06/30/2006
Last Update Date : 03/31/2021

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