MEDICARE: DR. LORELI K. OKA M.D.

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
1	207RG0100X	Gastroenterology Physician	MD-12785	HI

General Provider Information

NPI Number	:	1922112648
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LORELI K. OKA M.D.

Provider Business Mailing Address
First Line	:	75-240 NANI KAILUA DRIVE
Second Line	:	SUITE 157
City	:	KAILUA-KONA
State	:	HI
Zip	:	96740-1780
Country	:	US
Telephone Number	:	808-329-9744
Fax Number	:	808-329-6646

Provider Business Practice Location Address
First Line	:	75-240 NANI KAILUA DRIVE
Second Line	:	SUITE 157
City	:	KAILUA-KONA
State	:	HI
Zip	:	96740-1780
Country	:	US
Telephone Number	:	808-329-9744
Fax Number	:	808-329-6646

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	09/28/2010

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