Provider Demographics
NPI:1023325370
Name:WINSTON Y OTA, M.D., INC
Entity type:Organization
Organization Name:WINSTON Y OTA, M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WINSTON
Authorized Official - Middle Name:Y
Authorized Official - Last Name:OTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-735-9093
Mailing Address - Street 1:PO BOX 11600
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96828-0600
Mailing Address - Country:US
Mailing Address - Phone:808-735-9093
Mailing Address - Fax:
Practice Address - Street 1:27 NIUHI ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96821-1516
Practice Address - Country:US
Practice Address - Phone:808-735-9093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-9062207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI07534901Medicaid
HI0000202465OtherHMSA