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General NPI Number Information
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NPI Number | 1588410807
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Entity Type | Individual
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Provider Name | HAZEL LOU CARONONGAN LOPEZ
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Gender | Female
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Dates
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Enumeration Date | 04/26/2024
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Last Update Date | 04/26/2024
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Provider Practice Location Address
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Address Line | 500 ALA MOANA BLVD STE 1
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City | HONOLULU
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State | HI
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Zip | 96813-4920
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Country | US
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Telephone | 800-896-1464
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Fax | 877-232-5455
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Provider Business Mailing Address
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Address Line | 91-1047 PUAINA ST
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City | EWA BEACH
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State | HI
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Zip | 96706-1839
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Country | US
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Telephone | 315-286-7373
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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 | PH-5050
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License Number State | HI
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