Individual
MR. JOSEPH LINCOLN DIAZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2001 VICTOR WHARF ACCESS RD, PEARL CITY, HI 96782-3400
(808) 474-2532
(808) 474-9495
Mailing address
2001 VICTOR WHARF ACCESS RD, PEARL CITY, HI 96782-3400
(808) 474-2532
(808) 474-9495
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1125287944
TRICARE
—
Enumeration date
11/09/2021
Last updated
11/09/2021
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