Basic Information
Provider Information
NPI: 1225530421
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MUKAI
FirstName: SHAUNA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: PHARMD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2470 S KING ST
Address2:  
City: HONOLULU
State: HI
PostalCode: 968265808
CountryCode: US
TelephoneNumber: 8089472651
FaxNumber:  
Practice Location
Address1: 2470 S KING ST
Address2:  
City: HONOLULU
State: HI
PostalCode: 968265808
CountryCode: US
TelephoneNumber: 8089472651
FaxNumber: 8089424144
Other Information
ProviderEnumerationDate: 03/03/2018
LastUpdateDate: 03/03/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000XPH-2137HIY Pharmacy Service ProvidersPharmacist 

No ID Information.


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