Provider Demographics
NPI:1851559744
Name:MAYER, JAMES SANFORD (DO,)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:SANFORD
Last Name:MAYER
Suffix:
Gender:M
Credentials:DO,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1237
Mailing Address - Street 2:
Mailing Address - City:KULA
Mailing Address - State:HI
Mailing Address - Zip Code:96790-1237
Mailing Address - Country:US
Mailing Address - Phone:808-876-1984
Mailing Address - Fax:808-876-1984
Practice Address - Street 1:7860 KULA HWY
Practice Address - Street 2:
Practice Address - City:KULA
Practice Address - State:HI
Practice Address - Zip Code:96790-7404
Practice Address - Country:US
Practice Address - Phone:808-876-1984
Practice Address - Fax:808-876-1984
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDOS 00341207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine