1336746478 NPI number — DR. ROSS THOMAS FUJIMORI PASCUAL PHARMD

Table of content: DR. ROSS THOMAS FUJIMORI PASCUAL PHARMD (NPI 1336746478)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336746478 NPI number — DR. ROSS THOMAS FUJIMORI PASCUAL PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PASCUAL
Provider First Name:
ROSS
Provider Middle Name:
THOMAS FUJIMORI
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336746478
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/01/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1201 WILDER AVE APT 2904
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HONOLULU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96822-3151
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-352-0387
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
750 KEEAUMOKU STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96814
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-941-6719
Provider Business Practice Location Address Fax Number:
808-941-6729
Provider Enumeration Date:
10/01/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  PH-3230 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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