Provider Demographics
NPI:1508565292
Name:PARK, ANGELYN SEOL (PHARM D)
Entity Type:Individual
Prefix:
First Name:ANGELYN
Middle Name:SEOL
Last Name:PARK
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1841 ALAWEO ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96821-1343
Mailing Address - Country:US
Mailing Address - Phone:808-429-4952
Mailing Address - Fax:
Practice Address - Street 1:1451 S KING ST STE 203A
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2568
Practice Address - Country:US
Practice Address - Phone:808-379-2347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH-4879183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist