Provider Demographics
NPI:1609077460
Name:NITTA, TODD BRANDON (RPH)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:BRANDON
Last Name:NITTA
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 1:86-120 FARRINGTON HWY
Practice Address - Street 2:
Practice Address - City:WAIANAE
Practice Address - State:HI
Practice Address - Zip Code:96792-3000
Practice Address - Country:US
Practice Address - Phone:808-696-7059
Practice Address - Fax:808-696-0793
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
HI2552183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist