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NPI Code Detail

MEDICARE: MICHAEL TSUTOMU HIRONAKA RPH

MEDICARE: MICHAEL TSUTOMU HIRONAKA RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist76159CA

General Provider Information

NPI Number : 1760907604
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL TSUTOMU HIRONAKA RPH
Provider Business Mailing Address
First Line : 75 N HAM LN
Second Line :
City : LODI
State : CA
Zip : 95242-2700
Country : US
Telephone Number : 209-369-8575
Fax Number : 209-369-1729
Provider Business Practice Location Address
First Line : 75 N HAM LN
Second Line :
City : LODI
State : CA
Zip : 95242-2700
Country : US
Telephone Number : 209-369-8575
Fax Number : 209-369-1729
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2017
Last Update Date : 08/12/2017

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