| Soma Clinic LLC | |
|
2155 Kalakaua Ave Ste 112 Honolulu HI 96815-2354 | |
| (808) 358-2182 | |
| (808) 900-5797 |
| Full Name | Soma Clinic LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 2155 Kalakaua Ave Ste 112, Honolulu, Hawaii |
| Authorized Official Name and Position | Yoichi Soma (MEMBER) |
| Authorized Official Contact | 8087224135 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Soma Clinic LLC 2155 Kalakaua Ave Ste 112 Honolulu HI 96815-2354 Ph: (808) 358-2182 | Soma Clinic LLC 2155 Kalakaua Ave Ste 112 Honolulu HI 96815-2354 Ph: (808) 358-2182 |
| NPI Number | 1194415935 |
|---|---|
| Provider Enumeration Date | 05/12/2023 |
| Last Update Date | 05/12/2023 |
| Certification Date | 05/12/2023 |
| Medicare PECOS PAC ID | 4789120940 |
|---|---|
| Medicare Enrollment ID | O20240724000492 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194415935 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (NU) | Primary |
| 363L00000X | Nurse Practitioner | (NU) | Secondary |
| Provider Name | Yoichi C Soma |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497809032 PECOS PAC ID: 6305930421 Enrollment ID: I20070920000402 |
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