Benjamin Jacob Gomez, IDC

Individual provider Military Health Care Provider · NPI 1801445663

Benjamin Jacob Gomez, IDC is a Military Health Care Provider in Pearl City, Hawaii. Practices as a sole proprietor. Registered with an NPI since 2019.

In the registry since: 2019
Specialties on file: 6

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Practice location Address checks out

2001 Victor Wharf
Pearl City, HI 96782
Phone: (954) 614-7005

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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Independent Duty Corpsman (primary)	Taxonomy 1710I1002X
Military Health Care Provider	Taxonomy 171000000X
Independent Duty Medical Technicians	Taxonomy 1710I1003X
Military Outpatient Operational (Transportable) Component Clinic/Center	Taxonomy 261QM1102X
Military Ambulatory Procedure Visits Operational (Transportable) Clinic/Center	Taxonomy 261QM1103X
Military Hospital	Taxonomy 286500000X

Record details

NPI number	1801445663
Entity type	Individual (Type 1)
Gender	Male
Credentials	IDC
Sole proprietor	Yes
NPI enumerated	September 5, 2019
Last updated in NPPES	December 17, 2019
Certification date	December 17, 2019
Mailing address	2001 Victor Wharf, Pearl City, HI 96782