Healthcare Provider Details

I. General information

NPI: 1992382964
Provider Name (Legal Business Name): TIFFANY ALICIA VALLESTEROS BIHIS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 03/25/2021
Certification Date: 03/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94-449 AKOKI ST STE 102
WAIPAHU HI
96797-2732
US

IV. Provider business mailing address

1001 QUEEN ST APT 906
HONOLULU HI
96814-4195
US

V. Phone/Fax

Practice location:
  • Phone: 808-671-5511
  • Fax: 808-671-5522
Mailing address:
  • Phone: 808-366-1900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH-4618
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: