Provider Demographics
NPI:1235200718
Name:ODA OHANA CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:ODA OHANA CHIROPRACTIC LLC
Other - Org Name:ODA OHANA CHIROPRACTIC AND THERAPEUTIC MASSAGE LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PARIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ODA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:808-942-2232
Mailing Address - Street 1:1481 S KING ST STE 438
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-2605
Mailing Address - Country:US
Mailing Address - Phone:808-942-2232
Mailing Address - Fax:808-942-2234
Practice Address - Street 1:1481 S KING ST STE 438
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2605
Practice Address - Country:US
Practice Address - Phone:808-942-2232
Practice Address - Fax:808-942-2234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1066111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI101676Medicare ID - Type Unspecified