Provider Demographics
NPI:1972934826
Name:OHARA, JOHN PHILIP (LAC DIPL OM)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:PHILIP
Last Name:OHARA
Suffix:
Gender:M
Credentials:LAC DIPL OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 OXFORD RD
Mailing Address - Street 2:APARTMENT 2
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-1342
Mailing Address - Country:US
Mailing Address - Phone:310-977-4019
Mailing Address - Fax:
Practice Address - Street 1:2335 ATHENS AVE
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-2818
Practice Address - Country:US
Practice Address - Phone:310-977-4019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-03
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15485171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist