Provider Demographics
NPI:1538483979
Name:MA, CAROLYN SHEONG JUN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:SHEONG JUN
Last Name:MA
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 1:34 RAINBOW DR
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-2056
Mailing Address - Country:US
Mailing Address - Phone:808-933-3870
Mailing Address - Fax:
Practice Address - Street 1:34 RAINBOW DR
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2056
Practice Address - Country:US
Practice Address - Phone:808-933-3870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-14
Last Update Date:2010-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH-11741835P1200X
CARPH 405451835P1200X
NV093581835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy