Provider Demographics
NPI:1710459300
Name:MEL A ONA M D INCORPORATED
Entity Type:Organization
Organization Name:MEL A ONA M D INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:ONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-319-4484
Mailing Address - Street 1:590 FARRINGTON HWY UNIT 526A
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-2034
Mailing Address - Country:US
Mailing Address - Phone:808-762-2311
Mailing Address - Fax:808-376-8780
Practice Address - Street 1:590 FARRINGTON HWY UNIT 526A
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-2034
Practice Address - Country:US
Practice Address - Phone:808-762-2311
Practice Address - Fax:808-376-8780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-20
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI816548Medicaid