Individual
LUIS CARLOS OMPHROY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
98-1079 MOANALUA RD, SUITE 680, AIEA, HI 96701-4713
(808) 487-7700
(808) 488-4151
Mailing address
98-1079 MOANALUA RD, SUITE 680, AIEA, HI 96701-4713
(808) 487-7700
(808) 488-4151
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD11461
HI
207W00000X
Ophthalmology Physician
Primary
MD-11461
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11461
MD
HI
05
—
D0228777
—
HI
Enumeration date
12/19/2006
Last updated
02/08/2019
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