Provider Demographics
NPI:1174674972
Name:OISHI, HENRY AKEMI (OD)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:AKEMI
Last Name:OISHI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31843 RANCHO CALIFORNIA RD
Mailing Address - Street 2:STE 100
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-5120
Mailing Address - Country:US
Mailing Address - Phone:310-301-0846
Mailing Address - Fax:310-301-0846
Practice Address - Street 1:31843 RANCHO CALIFORNIA RD
Practice Address - Street 2:SUITE 100
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-5120
Practice Address - Country:US
Practice Address - Phone:951-587-6500
Practice Address - Fax:951-587-6550
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT12717 TPA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWOP12717Medicare ID - Type Unspecified