Provider Demographics
NPI:1306998570
Name:CORSON, RAMONA KEIKO LEE (RPH, PHARMD,)
Entity type:Individual
Prefix:DR
First Name:RAMONA
Middle Name:KEIKO LEE
Last Name:CORSON
Suffix:
Gender:F
Credentials:RPH, PHARMD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 DAIRY ROAD
Mailing Address - Street 2:SUITE E-143
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732
Mailing Address - Country:US
Mailing Address - Phone:808-242-4044
Mailing Address - Fax:808-243-6630
Practice Address - Street 1:80 MAHALANI STREET
Practice Address - Street 2:KAISER WAILUKU CLINIC
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793
Practice Address - Country:US
Practice Address - Phone:808-243-6106
Practice Address - Fax:808-243-6630
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH - 11151835P1200X
CARPH 478491835P1200X
PARP035379L1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy