Provider Information for 1932813060
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JONATHAN BRYON MARTIN
Sex: Male
NPI: 1932813060
Last Updated: 2025-02-18
Certification Date: 2025-02-18
Certification Date: 2025-02-18
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1932813060 | ||||||||||||
| Enumeration Date | 2023-01-12 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 92-1209 HAUONE ST KAPOLEI, HI 96707-1543 United States Phone: 808-462-8528 | Fax: | ||||||||||||
| Primary Practice Address | 95-1091 AINAMAKUA DR MILILANI, HI 96789-4252 United States Phone: 808-204-4020 | Fax: | ||||||||||||
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