Healthcare Provider Details

I. General information

NPI: 1336768514
Provider Name (Legal Business Name): KARA KRISTA YAMANE-OBANA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2020
Last Update Date: 04/08/2020
Certification Date: 04/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

888 S KING ST
HONOLULU HI
96813-3097
US

IV. Provider business mailing address

2848 OAHU AVE
HONOLULU HI
96822-1726
US

V. Phone/Fax

Practice location:
  • Phone: 808-522-4354
  • Fax:
Mailing address:
  • Phone: 808-220-9608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberPH-1596
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: