Provider Demographics
NPI:1003356320
Name:OHANA KIDS & FAMILY KARE LLC
Entity Type:Organization
Organization Name:OHANA KIDS & FAMILY KARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUZ
Authorized Official - Middle Name:ANGELA
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-889-4565
Mailing Address - Street 1:3130 E BASELINE RD STE 103
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-7290
Mailing Address - Country:US
Mailing Address - Phone:480-539-7618
Mailing Address - Fax:480-900-8884
Practice Address - Street 1:3130 E BASELINE RD STE 103
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-7290
Practice Address - Country:US
Practice Address - Phone:480-539-7618
Practice Address - Fax:480-900-8884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty