Provider Demographics
NPI:1063512630
Name:OSHIRO, ERNEST K (OD)
Entity type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:K
Last Name:OSHIRO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 NUUANU AVE STE C102
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-4018
Mailing Address - Country:US
Mailing Address - Phone:808-533-3236
Mailing Address - Fax:808-524-3194
Practice Address - Street 1:1255 NUUANU AVE STE C102
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-4018
Practice Address - Country:US
Practice Address - Phone:808-533-3236
Practice Address - Fax:808-524-3194
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-24
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI230152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI50807Medicare PIN