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Individual

MARYAM KHAYAMI GOCA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
128 LEHUA ST, WAHIAWA, HI 96786
(808) 621-4355
Mailing address
407 ULUNIU ST STE 411, KAILUA, HI 96734-2544
(088) 263-7203

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
AMD-750
HI
363AM0700X
Medical Physician Assistant
PA9108560
FL

Other

Enumeration date
02/09/2015
Last updated
10/04/2018
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