Provider Demographics
NPI:1437165396
Name:OMPHROY, CARLOS A (M D)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:A
Last Name:OMPHROY
Suffix:
Gender:M
Credentials:M D
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Mailing Address - Street 1:95-720 LANIKUHANA AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-2985
Mailing Address - Country:US
Mailing Address - Phone:808-625-5577
Mailing Address - Fax:808-625-1221
Practice Address - Street 1:95-720 LANIKUHANA AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-2985
Practice Address - Country:US
Practice Address - Phone:808-625-5577
Practice Address - Fax:808-625-1221
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2009-06-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
HIMD4936207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI01649901Medicaid
HIC01766-9OtherHMSA
HI01649901Medicaid
HIC98575Medicare UPIN