Healthcare Provider Details

I. General information

NPI: 1831424282
Provider Name (Legal Business Name): MICHAEL JOHNSON HSU PHARM D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2009
Last Update Date: 08/08/2023
Certification Date: 08/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 SCOTT CIR
HICKAM AFB HI
96853-5399
US

IV. Provider business mailing address

755 SCOTT CIR
HICKAM AFB HI
96853-5399
US

V. Phone/Fax

Practice location:
  • Phone: 808-448-6715
  • Fax:
Mailing address:
  • Phone: 808-448-6715
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH72826
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: