Provider Demographics
NPI:1033548417
Name:LOPEZ, CHERYL M (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:M
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74-5455 MAKALA BLVD
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-2727
Mailing Address - Country:US
Mailing Address - Phone:808-334-4021
Mailing Address - Fax:
Practice Address - Street 1:74-5455 MAKALA BLVD
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-2727
Practice Address - Country:US
Practice Address - Phone:808-334-4021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH-3600183500000X
CA70141183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist