DAVID MALDONADO SANTIAGO


Address: 590 Moffet St, Jbphh, HI 96853-5168
Phone: 8084484500

DAVID MALDONADO SANTIAGO (NPI# 1134759715) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1134759715
Entity Type Individual
Full Name DAVID MALDONADO SANTIAGO
Other Name DAVID MALDONADO
Credential IDC
Practice Address 590 Moffet St
Jbphh
HI 96853-5168
Mailing Address 3710 Wabash Ave Apt 105
San Diego
CA 92104-3960
Practice Telephone 8084484500
Mailing Telephone 2247724927
Enumeration Date 2020-01-22
Last Update Date 2020-01-23
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1710I1002X Military Health Care Provider
Specialization: Independent Duty Corpsman
Other Service Providers
N 1710I1003X Military Health Care Provider
Specialization: Independent Duty Medical Technicians
Other Service Providers

Office Location

Street Address 590 MOFFET ST
City JBPHH
State HI
Zip Code 96853-5168

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1467884759 Edward Joseph Tucholski Jr. Dentist 15 Mdg, 755 Scott Circle, Jbphh, HI 96853 2013-08-08
1922232230 Angela Marie Alveo-forbes Military Health Care Provider 375 Mamiya St, Bldg 2140, Hickam Ab, HI 96853 2009-05-14
1205180783 John-michael Fowler Registered Nurse 755 Scott Circle, Jbphh, HI 96853 2012-11-05
1811250442 April A Bronowski Physical Therapist 755 Scott Circle, 15 Mdg, Joint Base Pearl Harbor Hickam, HI 96853 2012-06-19
1245557438 Elaine Mae Davis Dietitian, Registered 755 Scott Cir, Jbphh, HI 96853 2010-04-27
1851492839 Matthew G Hoyt Family Medicine 755 Scott Cir, Jbphh, HI 96853 2006-09-25
1609812163 Joyce Ann Raszewski Nurse Practitioner 755 Scott Circle, Jbphh/hickam, HI 96853 2006-06-22
1720068976 Richard Dale Quintana Family Medicine 15th Medical Group, Hickam Afb, Honolulu, HI 96853 2006-01-21
1124262746 John Craig Bright Military Health Care Provider 15mdos/sgomf 755 Scott Circle, Hickam Afb, HI 96853-3672 2009-04-27
1366427395 Lisa Katherine Rivera Pathology 590 Moffet St, Bldg 4077, Joint Base Pearl Harbor-hickam, Honolulu, HI 96853-5168 2005-12-13
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Taxonomy Information

Taxonomy Code 1710I1002X
Grouping Other Service Providers
Classification Military Health Care Provider
Specialization Independent Duty Corpsman

Taxonomy Definition

A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.
Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1821502683 Matthew Laurance Reagan Military Health Care Provider 480 Central Ave, Jbphh, HI 96860-4908 2017-11-30
1437574928 Guy Edward Sargent Military Health Care Provider 480 Central Ave, Jbphh, HI 96860 2014-02-20
1740527589 Cory John Butler Military Health Care Provider 310 Worchester Ave Bldg 45, Jbphh, HI 96853-5530 2013-01-14

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1205441888 William Andrew Fitzpatrick Military Health Care Provider Bldg 6905, Mcbh, HI 96734 2020-09-10
1215549670 Joseph Frabotta Military Health Care Provider 6894r Mokapu Rd, Kailua, HI 96734 2020-08-18
1508484882 David Jason Brown Military Health Care Provider 6255 Kaawa St, Kailua, HI 96734-4984 2020-07-13
1003325366 Justin Hesse Military Health Care Provider Building 17 Bishop Point, Pearl Harbor, HI 96860 2017-09-29
1649796244 Joshua I White Military Health Care Provider Bldg 4078 Harris Rd., Mcbh Kaneohe Bay, HI 96863 2017-08-16
1104290519 Carlton Jacob Maughan Military Health Care Provider Bldg 17 Bishops Point, Pearl Harbor, HI 96860 2015-11-23
1811363120 Timothy Layton Military Health Care Provider 1016 Ulupau Loop, Kailua, HI 96734-4772 2015-08-20
1700263001 Daniel Joseph Engelhardt Military Health Care Provider 5435 Kilmer Ln, Honolulu, HI 96818-3467 2015-05-06
1316350168 Bryan Goodman Military Health Care Provider Bldg #1058, Mcbh Kaneohe Bay, HI 96863 2014-06-10
1902249436 Alex Joseph Valencia Military Health Care Provider 3005 Glen Cove, Kailua, HI 96734-3004 2013-04-15
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Competitor

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City JBPHH
Zip Code 96853

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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