Individual
HIRO ODA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1313 S HARBOR BLVD, ANAHEIM, CA 92802-2309
(714) 512-7932
Mailing address
1313 S HARBOR BLVD, ANAHEIM, CA 92802-2309
(714) 512-7932
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000003000
CA
Other
Enumeration date
09/23/2019
Last updated
09/23/2019
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