Provider Demographics
NPI:1922112648
Name:OKA, LORELI K (MD)
Entity Type:Individual
Prefix:DR
First Name:LORELI
Middle Name:K
Last Name:OKA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:75-240 NANI KAILUA DRIVE
Mailing Address - Street 2:SUITE 157
Mailing Address - City:KAILUA-KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-1780
Mailing Address - Country:US
Mailing Address - Phone:808-329-9744
Mailing Address - Fax:808-329-6646
Practice Address - Street 1:75-240 NANI KAILUA DRIVE
Practice Address - Street 2:SUITE 157
Practice Address - City:KAILUA-KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-1780
Practice Address - Country:US
Practice Address - Phone:808-329-9744
Practice Address - Fax:808-329-6646
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-12785207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH53563Medicare UPIN