Individual
COREY OMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
94-1105 AWALUA ST, WAIPAHU, HI 96797-5327
(808) 425-3587
Mailing address
94-1105 AWALUA ST, WAIPAHU, HI 96797-5327
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN-89024
HI
Other
Enumeration date
09/16/2020
Last updated
09/16/2020
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