Individual
KYLE JAMES PEDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6905 HARRIS AVE, KAILUA, HI 96734
(808) 257-3365
Mailing address
MAG-24 MWSS, MCBH BOX 63047, MCBH KANEOHE BAY, HI 96863-3047
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/24/2021
Last updated
04/14/2022
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