1518948975 NPI number — MR. SANTO JOHN DIMARTINO P.A.-C

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518948975 NPI number — MR. SANTO JOHN DIMARTINO P.A.-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DIMARTINO
Provider First Name:
SANTO
Provider Middle Name:
JOHN
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
P.A.-C
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518948975
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/09/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
91-1088 LAAULU ST
Provider Second Line Business Mailing Address:
A
Provider Business Mailing Address City Name:
EWA BEACH
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96706-4300
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-683-5464
Provider Business Mailing Address Fax Number:
808-683-5464

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
480 CENTRAL AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PEARL HARBOR
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96860-4908
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-473-1880
Provider Business Practice Location Address Fax Number:
808-473-4411
Provider Enumeration Date:
11/10/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363AM0700X , with the licence number:  AMD-41 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com