Provider Demographics
NPI:1407981178
Name:OSHIRO, MARCUS TERUO (AT,C)
Entity Type:Individual
Prefix:
First Name:MARCUS
Middle Name:TERUO
Last Name:OSHIRO
Suffix:
Gender:M
Credentials:AT,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 S BERETANIA ST STE 100
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-5702
Mailing Address - Country:US
Mailing Address - Phone:808-533-4545
Mailing Address - Fax:808-533-1656
Practice Address - Street 1:800 S BERETANIA ST STE 100
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-5702
Practice Address - Country:US
Practice Address - Phone:808-533-4545
Practice Address - Fax:808-533-1656
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer