NPI 1740957158

Kyle James Pederson

Practitioner Independent Duty Corpsman Kailua, HI

Practice location

Address: 6905 Harris Ave, Kailua, HI 96734
Phone: (808) 257-3365
Mailing address: Mag-24 Mwss McBh Box 63047, McBh Kaneohe Bay, HI 96863-3047

Registered specialties (2)

Independent Duty Corpsman Primary

Other Service Providers Taxonomy 1710I1002X

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Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1740957158
Entity type: Individual
Sex (as registered): Male
NPI issued: 24 Aug 2021
Record last updated: 14 Apr 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.