Provider Demographics
NPI:1316446420
Name:HASEGAWA, DEREK YOSHIO (PHARMD)
Entity type:Individual
Prefix:
First Name:DEREK
Middle Name:YOSHIO
Last Name:HASEGAWA
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 1:2750 WOODLAWN DR
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-1841
Mailing Address - Country:US
Mailing Address - Phone:808-988-2151
Mailing Address - Fax:808-988-9319
Practice Address - Street 1:2750 WOODLAWN DR
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96822-1841
Practice Address - Country:US
Practice Address - Phone:808-988-2151
Practice Address - Fax:808-988-9319
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-04
Last Update Date:2018-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2385183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist