Provider Demographics
NPI:1588922025
Name:MARTINEZ, MALIA KUUIPO (CSAC)
Entity type:Individual
Prefix:MS
First Name:MALIA
Middle Name:KUUIPO
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86-120 FARRINGTON HWY STE A107
Mailing Address - Street 2:
Mailing Address - City:WAIANAE
Mailing Address - State:HI
Mailing Address - Zip Code:96792-3071
Mailing Address - Country:US
Mailing Address - Phone:808-688-6588
Mailing Address - Fax:808-696-5079
Practice Address - Street 1:86-120 FARRINGTON HWY STE A107
Practice Address - Street 2:
Practice Address - City:WAIANAE
Practice Address - State:HI
Practice Address - Zip Code:96792-3071
Practice Address - Country:US
Practice Address - Phone:808-688-6588
Practice Address - Fax:808-696-5079
Is Sole Proprietor?:No
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator