Healthcare Provider Details

I. General information

NPI: 1518045004
Provider Name (Legal Business Name): LISA TOKUDA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 11/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

459 PATTERSON RD
HONOLULU HI
96819-1522
US

IV. Provider business mailing address

1488 ALA NAPUNANI ST
HONOLULU HI
96818-1524
US

V. Phone/Fax

Practice location:
  • Phone: 808-833-2331
  • Fax:
Mailing address:
  • Phone: 808-833-2331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number59083
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: