Edward O'Hara, M.D.

Individual provider Active NPI General Practice Physician · Corning, CA

NPI 1124313093 · NPPES record last updated Jan 20, 2014

Key facts

NPI
1124313093
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Physician 208D00000X
License
A126209 (CA)
Practice address
155 Solano St
Corning, CA 96021-3511
Phone
(530) 824-4663
NPI assigned
Jun 18, 2011
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11015962AINMDSurgery Physician
A126209CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edward Ohara MD General Practice Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 11015962A IN
General Practice Physician 208D00000X A126209 CA Yes

Addresses

Primary practice location

155 Solano St
Corning, CA 96021-3511

Mailing address

155 Solano St
Corning, CA 96021-3511
Phone (530) 824-4663

Other providers in Corning, CA

All providers in Corning, CA · General Practice Physician in California

Sources for this page

Verify at the official NPI Registry.