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General NPI Number Information
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NPI Number | 1376450080
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Entity Type | Individual
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Provider Name | BERT MATSUO PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/26/2026
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Last Update Date | 08/26/2026
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Provider Practice Location Address
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Address Line | 550 S BERETANIA ST STE 610
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City | HONOLULU
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State | HI
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Zip | 96813-2496
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Country | US
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Telephone | 808-691-8900
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Fax | 808-691-8919
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Provider Business Mailing Address
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Address Line | 1456 THURSTON AVE APT 1404
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City | HONOLULU
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State | HI
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Zip | 96822-3639
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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 | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | PH-4324
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License Number State | HI
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