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General NPI Number Information
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NPI Number | 1073170106
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Entity Type | Individual
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Provider Name | LISSA ISHIHARA
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Gender | Female
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Dates
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Enumeration Date | 05/23/2019
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Last Update Date | 05/23/2019
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Provider Practice Location Address
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Address Line | 2828 PAA ST
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City | HONOLULU
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State | HI
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Zip | 96819-4430
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Country | US
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Telephone | 808-432-9530
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Fax |
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Provider Business Mailing Address
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Address Line | 2238 BARBARA WAY
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City | UPLAND
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State | CA
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Zip | 91784-1265
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 4353
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 78818
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License Number State | CA
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