Provider Demographics
NPI:1376744128
Name:KANNO, GERALD M (RPH)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:M
Last Name:KANNO
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 1:141 N CIVIC DR
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-3815
Mailing Address - Country:US
Mailing Address - Phone:925-210-6659
Mailing Address - Fax:925-210-6606
Practice Address - Street 1:1088 BISHOP ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3101
Practice Address - Country:US
Practice Address - Phone:808-536-5706
Practice Address - Fax:808-599-3946
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI837183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist