Basic Information
Provider Information
NPI: 1891750345
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HIRNIAK
FirstName: OKSANA
MiddleName: B
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 332 S JUNIPER ST
Address2: SUITE 100
City: ESCONDIDO
State: CA
PostalCode: 920254941
CountryCode: US
TelephoneNumber: 8662282236
FaxNumber: 7607373430
Practice Location
Address1: 277 RANCHEROS DR
Address2: SUITE 100
City: SAN MARCOS
State: CA
PostalCode: 920692976
CountryCode: US
TelephoneNumber: 8662282236
FaxNumber: 7607373430
Other Information
ProviderEnumerationDate: 04/18/2006
LastUpdateDate: 11/18/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/18/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X20A11789CAY Allopathic & Osteopathic PhysiciansFamily Medicine 

ID Information
IDTypeStateIssuerDescription
ER453Y01CAMEDICARE PTANOTHER


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