Basic Information
| Provider Information | |||||||||
| NPI: | 1598749640 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OYAMA | ||||||||
| FirstName: | IAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1319 PUNAHOU ST | ||||||||
| Address2: | STE 824 | ||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968261001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8082036519 | ||||||||
| FaxNumber: | 8089552174 | ||||||||
| Practice Location | |||||||||
| Address1: | 1319 PUNAHOU ST | ||||||||
| Address2: | STE 801 | ||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968261001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8089495305 | ||||||||
| FaxNumber: | 8089552174 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/02/2005 | ||||||||
| LastUpdateDate: | 11/22/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | MD11095 | HI | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207VF0040X | MD11095 | HI | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Female Pelvic Medicine and Reconstructive Surgery |
ID Information
| ID | Type | State | Issuer | Description | 568595 | 05 | HI | MEDICAID |