Provider Demographics
NPI:1285266767
Name:KAJIWARA, GERALD M
Entity type:Individual
Prefix:
First Name:GERALD
Middle Name:M
Last Name:KAJIWARA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95-317 POIKI ST
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-1883
Mailing Address - Country:US
Mailing Address - Phone:808-265-2765
Mailing Address - Fax:
Practice Address - Street 1:66-197 KAMEHAMEHA HWY
Practice Address - Street 2:
Practice Address - City:HALEIWA
Practice Address - State:HI
Practice Address - Zip Code:96712-1400
Practice Address - Country:US
Practice Address - Phone:808-637-9393
Practice Address - Fax:808-637-8875
Is Sole Proprietor?:No
Enumeration Date:2020-02-12
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI729183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist