Basic Information
| Provider Information | |||||||||
| NPI: | 1104909670 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | UOHARA | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | K | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | UOHARA, M.D., INC. | ||||||||
| OtherFirstName: | JOHN | ||||||||
| OtherMiddleName: | K | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 82 PUUHONU PL | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | HILO | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967202010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8089616608 | ||||||||
| FaxNumber: | 8089347445 | ||||||||
| Practice Location | |||||||||
| Address1: | 82 PUUHONU PL | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | HILO | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967202010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8089616608 | ||||||||
| FaxNumber: | 8089347445 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/20/2006 | ||||||||
| LastUpdateDate: | 01/18/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | MD2891 | HI | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 03712401 | 05 | HI | MEDICAID | 40881 | 01 | HI | HMSA | OTHER |