Healthcare Provider Details

I. General information

NPI: 1750267316
Provider Name (Legal Business Name): SAMANTHA OKUBO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2025
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

848 ALA LILIKOI ST
HONOLULU HI
96818-2144
US

IV. Provider business mailing address

801 ALA NIOI PL APT 105
HONOLULU HI
96818-3017
US

V. Phone/Fax

Practice location:
  • Phone: 808-833-2597
  • Fax:
Mailing address:
  • Phone: 847-683-7034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH-5153
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: