Provider Demographics
NPI:1235727561
Name:ALAN KOJIMA
Entity Type:Organization
Organization Name:ALAN KOJIMA
Other - Org Name:CENTRAL OAHU MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOJIMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-927-0183
Mailing Address - Street 1:302 CALIFORNIA AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:WAHIAWA
Mailing Address - State:HI
Mailing Address - Zip Code:96786-1841
Mailing Address - Country:US
Mailing Address - Phone:808-927-0183
Mailing Address - Fax:
Practice Address - Street 1:302 CALIFORNIA AVE STE 210
Practice Address - Street 2:
Practice Address - City:WAHIAWA
Practice Address - State:HI
Practice Address - Zip Code:96786-1841
Practice Address - Country:US
Practice Address - Phone:808-927-0183
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-03
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1427461268Medicaid