Active NPI
Gwynne Gonzales
- Pharmacist
- Mililani, HI
National Provider Identifier
1124789292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH-4062
- Practice address
- 95-1077 Ainamakua Dr
Mililani, HI 96789-4252 - Phone
- (808) 626-2380
- NPI assigned
- Dec 31, 2021
- Last updated
- Dec 31, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH-4062 | HI | Primary |
Addresses
Primary practice location
95-1077 Ainamakua Dr
Mililani, HI 96789-4252
Mailing address
95-1077 Ainamakua Dr
Mililani, HI 96789-4252
Phone (808) 626-2380
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH-4062 | HI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Longs Drug Store California LLC | Past | Accepting new patients | |
| Longs Drug Stores California LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1640908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640908800000",
"number": "1124789292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "95-1077 AINAMAKUA DR",
"city": "MILILANI",
"state": "HI",
"postal_code": "967894252",
"telephone_number": "808-626-2380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95-1077 AINAMAKUA DR",
"city": "MILILANI",
"state": "HI",
"postal_code": "967894252",
"telephone_number": "808-626-2380"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALES",
"first_name": "GWYNNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-12-31",
"last_updated": "2021-12-31",
"certification_date": "2021-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "HI",
"license": "PH-4062",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mililani, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.