Provider Demographics
NPI:1467645770
Name:ERNEST K. OSHIRO
Entity Type:Organization
Organization Name:ERNEST K. OSHIRO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:KIYOSHI
Authorized Official - Last Name:OSHIRO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:808-533-3236
Mailing Address - Street 1:1255 NUUANU AVE STE C102
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-4018
Mailing Address - Country:US
Mailing Address - Phone:808-533-3236
Mailing Address - Fax:808-524-3194
Practice Address - Street 1:1255 NUUANU AVE STE C102
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-4018
Practice Address - Country:US
Practice Address - Phone:808-533-3236
Practice Address - Fax:808-524-3194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-20
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI230D152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00249301Medicaid
HI50807Medicare PIN
HI1231230001Medicare NSC
HI00249301Medicaid