Provider Demographics
NPI:1568043925
Name:DAGUIMOL, IAN FRANCIS (PHARMD)
Entity Type:Individual
Prefix:
First Name:IAN FRANCIS
Middle Name:
Last Name:DAGUIMOL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:IAN
Other - Middle Name:
Other - Last Name:DAGUIMOL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:94-216 FARRINGTON HWY STE 102
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-1900
Mailing Address - Country:US
Mailing Address - Phone:808-677-5550
Mailing Address - Fax:
Practice Address - Street 1:94-216 FARRINGTON HWY STE 102
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-1900
Practice Address - Country:US
Practice Address - Phone:808-677-5550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-17
Last Update Date:2021-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH-4019183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist