Provider Demographics
NPI:1508166133
Name:MIYAMOTO, KARL HIROYUKI (RPH)
Entity Type:Individual
Prefix:MR
First Name:KARL
Middle Name:HIROYUKI
Last Name:MIYAMOTO
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 1:2741 PALI HWY
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-1430
Mailing Address - Country:US
Mailing Address - Phone:808-595-2395
Mailing Address - Fax:
Practice Address - Street 1:1221 S BERETANIA ST
Practice Address - Street 2:
Practice Address - City:HONOLLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1625
Practice Address - Country:US
Practice Address - Phone:808-592-6487
Practice Address - Fax:808-592-6481
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-29
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI727183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist