Provider Demographics
NPI:1336233972
Name:OBRIEN, BENJAMIN (MD)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:OBRIEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:91-229 MAKAHOU PL
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-1943
Mailing Address - Country:US
Mailing Address - Phone:808-888-4877
Mailing Address - Fax:808-888-4877
Practice Address - Street 1:1 JARRETT WHITE ROAD
Practice Address - Street 2:TRIPLER ARMY MEDICAL CENTER
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96859-5000
Practice Address - Country:US
Practice Address - Phone:808-433-8199
Practice Address - Fax:808-433-8334
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT535863112052084P0800X
HI127382084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT006902213Medicare PIN