Healthcare Provider Details

I. General information

NPI: 1023160579
Provider Name (Legal Business Name): HAN THIDIEU HEPTON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2828 PAA ST SUITE # 2420A
HONOLULU HI
96819-4405
US

IV. Provider business mailing address

44-305A KANEOHE BAY DR.
KANEOHE HI
96744
US

V. Phone/Fax

Practice location:
  • Phone: 808-432-5775
  • Fax: 808-432-5709
Mailing address:
  • Phone: 808-254-2208
  • Fax: 808-432-5709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH 1980
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: