Healthcare Provider Details

I. General information

NPI: 1093083040
Provider Name (Legal Business Name): NANCY HUANG RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2011
Last Update Date: 12/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3375 KOAPAKA ST
HONOLULU HI
96819-1800
US

IV. Provider business mailing address

3375 KOAPAKA ST STE F23830
HONOLULU HI
96819-1815
US

V. Phone/Fax

Practice location:
  • Phone: 808-836-5078
  • Fax:
Mailing address:
  • Phone: 808-836-5078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number42468
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: