Provider Demographics
NPI:1033169628
Name:OISO, AKIO (MD)
Entity Type:Individual
Prefix:DR
First Name:AKIO
Middle Name:
Last Name:OISO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 KOKU LN
Mailing Address - Street 2:GUAM TRAVELERS CLINIC
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96913-3977
Mailing Address - Country:US
Mailing Address - Phone:671-647-7771
Mailing Address - Fax:671-647-7773
Practice Address - Street 1:175 KOKU LN
Practice Address - Street 2:GUAM TRAVELERS CLINIC
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913-3977
Practice Address - Country:US
Practice Address - Phone:671-647-7771
Practice Address - Fax:671-647-7773
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-077681208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GUM-1634OtherMEDICAL LICENSE
IL036077681OtherMEDICAL LICENSE
HI12176OtherMEDICAL LICENSE