Provider Demographics
NPI:1194415935
Name:SOMA CLINIC LLC
Entity type:Organization
Organization Name:SOMA CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:YOICHI
Authorized Official - Middle Name:
Authorized Official - Last Name:SOMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-722-4135
Mailing Address - Street 1:2155 KALAKAUA AVE STE 112
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-2354
Mailing Address - Country:US
Mailing Address - Phone:808-358-2182
Mailing Address - Fax:808-900-5797
Practice Address - Street 1:2155 KALAKAUA AVE STE 112
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-2354
Practice Address - Country:US
Practice Address - Phone:808-358-2182
Practice Address - Fax:808-900-5797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-12
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty