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Individual

MR. JAMES SOTTO MARTIN II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
IDC

Contact information

Practice address
BLDG. 6905 HARRIS AVE, KAILUA, HI 96734
(808) 257-3365
Mailing address
4005 SAN ANTONIO LN, KAILUA, HI 96734-4776
(619) 919-2640

Taxonomy

Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1088830020
DOD ID NUMBER
Enumeration date
10/25/2021
Last updated
06/15/2022
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