Provider Demographics
NPI:1689432833
Name:SHIMIZU, SERA (PHARMD)
Entity Type:Individual
Prefix:
First Name:SERA
Middle Name:
Last Name:SHIMIZU
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 1:1450 ALA MOANA BLVD STE 2004
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4671
Mailing Address - Country:US
Mailing Address - Phone:808-949-4010
Mailing Address - Fax:
Practice Address - Street 1:1450 ALA MOANA BLVD STE 2004
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4671
Practice Address - Country:US
Practice Address - Phone:808-949-4010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH4756183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist