Provider Demographics
NPI:1528498748
Name:TOM, SUNAE (PHARMD)
Entity type:Individual
Prefix:
First Name:SUNAE
Middle Name:
Last Name:TOM
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 1:3375 KOAPAKA ST
Mailing Address - Street 2:SUITE G320
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-1800
Mailing Address - Country:US
Mailing Address - Phone:808-840-5600
Mailing Address - Fax:
Practice Address - Street 1:3375 KOAPAKA ST
Practice Address - Street 2:SUITE G320
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-1800
Practice Address - Country:US
Practice Address - Phone:808-840-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-25
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH-15831835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
476879OtherNABP