Provider Demographics
NPI:1932354644
Name:CHENG, GORDON (PHARMD)
Entity Type:Individual
Prefix:
First Name:GORDON
Middle Name:
Last Name:CHENG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 KALAKAUA AVE APT 306
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-2434
Mailing Address - Country:US
Mailing Address - Phone:808-385-4480
Mailing Address - Fax:
Practice Address - Street 1:501 ALAKAWA ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-5700
Practice Address - Country:US
Practice Address - Phone:808-432-5526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-21
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2454183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
123456OtherEMERGENCY CONTRACEPTION