Provider Demographics
NPI:1386899631
Name:KOHARA, EUNICE MAYA (DO)
Entity type:Individual
Prefix:DR
First Name:EUNICE
Middle Name:MAYA
Last Name:KOHARA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3831 HUGHES AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-6834
Mailing Address - Country:US
Mailing Address - Phone:323-682-0289
Mailing Address - Fax:855-538-9401
Practice Address - Street 1:3831 HUGHES AVE STE 104
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-6834
Practice Address - Country:US
Practice Address - Phone:323-682-0289
Practice Address - Fax:855-538-9401
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-28
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY258651207W00000X
CA20A11347207WX0110X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus SpecialistGroup - Single Specialty