Provider Demographics
NPI:1003522533
Name:KANEKO, CHRISTOPHER CHAD (RPH)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:CHAD
Last Name:KANEKO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-919 FORT WEAVER RD
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-2257
Mailing Address - Country:US
Mailing Address - Phone:808-689-5860
Mailing Address - Fax:
Practice Address - Street 1:91-919 FORT WEAVER RD
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-2257
Practice Address - Country:US
Practice Address - Phone:808-689-5860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-27
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH-4890183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist