Provider Demographics
NPI:1538114541
Name:KATHLEEN OGINO PT LLC
Entity Type:Organization
Organization Name:KATHLEEN OGINO PT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:OGINO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:808-599-0045
Mailing Address - Street 1:92-1448 PALAHIA ST
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-3306
Mailing Address - Country:US
Mailing Address - Phone:808-599-0045
Mailing Address - Fax:808-591-0004
Practice Address - Street 1:1744 LILIHA STREET
Practice Address - Street 2:SUITE 102
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-3155
Practice Address - Country:US
Practice Address - Phone:808-599-0045
Practice Address - Fax:808-591-0004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT784261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00C0240915OtherTRIWEST
ID567414Medicaid
HI525690OtherSUMMERLIN
HI7848787OtherUHA
HI00C0240915OtherHMSA BASIC,65C/65C,HMO
HI00C0240915OtherHMSA BASIC,65C/65C+,HMO