Healthcare Provider Details

I. General information

NPI: 1366440901
Provider Name (Legal Business Name): JONATHAN B. JAMES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 03/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1031 NUUANU AVE #1504
HONOLULU HI
96817-5601
US

IV. Provider business mailing address

1031 NUUANU AVE #1504
HONOLULU HI
96817-5601
US

V. Phone/Fax

Practice location:
  • Phone: 808-557-0000
  • Fax: 866-257-2762
Mailing address:
  • Phone: 808-557-0000
  • Fax: 866-257-2762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD3580
License Number StateGU

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: