Provider Demographics
NPI:1417928516
Name:OHASHI, GARY M (MD)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:M
Last Name:OHASHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:15464 GOLDENWEST ST
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-6149
Mailing Address - Country:US
Mailing Address - Phone:714-891-9008
Mailing Address - Fax:174-893-2239
Practice Address - Street 1:15464 GOLDENWEST ST
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-6149
Practice Address - Country:US
Practice Address - Phone:714-891-9008
Practice Address - Fax:174-893-2239
Is Sole Proprietor?:No
Enumeration Date:2006-01-28
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG075201207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWG75201BMedicare PIN
CAWG75201AMedicare PIN