Individual
JESSE BLANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
770 KAPIOLANI BLVD, HONOLULU, HI 96813-5212
(808) 597-8778
Mailing address
94-1143 KALOLI LOOP, WAIPAHU, HI 96797-5427
(828) 381-4720
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
AMD-711
HI
Other
Enumeration date
10/04/2013
Last updated
10/08/2018
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