Healthcare Provider Details

I. General information

NPI: 1316062730
Provider Name (Legal Business Name): DEAN KUNIO FUJIMOTO RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 S KIHEI RD
KIHEI HI
96753-5220
US

IV. Provider business mailing address

141 N CIVIC DR
WALNUT CREEK CA
94596-3815
US

V. Phone/Fax

Practice location:
  • Phone: 808-879-2033
  • Fax: 808-874-7633
Mailing address:
  • Phone: 925-210-6660
  • Fax: 925-210-6606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2591
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: