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General NPI Number Information
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NPI Number | 1801249362
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Entity Type | Individual
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Provider Name | DOMINIC CERRA PHARM BS
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Gender | Male
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Dates
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Enumeration Date | 07/20/2016
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Last Update Date | 07/20/2016
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Provider Practice Location Address
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Address Line | 681 IMIHALE ST
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City | KIHEI
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State | HI
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Zip | 96753-6057
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Country | US
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Telephone | 949-235-6951
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Fax |
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Provider Business Mailing Address
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Address Line | 681 IMIHALE ST
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City | KIHEI
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State | HI
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Zip | 96753-6057
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Country | US
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Telephone | 949-235-6951
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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 3951
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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 | 44776
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP0356691
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License Number State | PA
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