Gomez, Benjamin Jacob
Gomez, Benjamin Jacob is an sole proprietor health care provider with primary practice located at 2001 Victor Wharf , Pearl City HI 96782. He recently has 6 registered licenses in different health care specialties including Other Service Providers / Military Health Care Provider, Other Service Providers / Independent Duty Medical Technicians, Ambulatory Health Care Facilities / Military Outpatient Operational (Transportable) Component, Ambulatory Health Care Facilities / Military Ambulatory Procedure Visits Operational (Transportable), Hospitals / Military Hospital, Other Service Providers / Independent Duty Corpsman. Other Service Providers / Independent Duty Corpsman is his primary health care specialty. Gomez, Benjamin Jacob can be contacted via phone (954) 614-7005.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Military Health Care Provider | 171000000X | ||
| Other Service Providers / Independent Duty Medical Technicians | 1710I1003X | ||
| Ambulatory Health Care Facilities / Military Outpatient Operational (Transportable) Component | 261QM1102X | ||
| Ambulatory Health Care Facilities / Military Ambulatory Procedure Visits Operational (Transportable) | 261QM1103X | ||
| Hospitals / Military Hospital | 286500000X | ||
| Other Service Providers / Independent Duty Corpsman | 1710I1002X |
Profile Details
| NPI number | 1801445663 |
|---|---|
| LBN Legal business name | Gomez, Benjamin Jacob |
| Credentials | IDC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 5th, 2019 |
| Last updated | Dec 17th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1801445663 | NPPES |
| Illinois | Other | 1384550807 | DOD ID |
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