Active NPI
Jackson Z Fong, PHARM.D
- Pharmacist
- Honolulu, HI
National Provider Identifier
1285778407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2219
- Practice address
- 3288 Moanalua Rd
Honolulu, HI 96819-1469 - Phone
- (808) 432-8121
- NPI assigned
- Feb 19, 2007
- Sex
- Male
- Sole proprietor
- No
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 | 2219 | HI | Primary |
Addresses
Primary practice location
3288 Moanalua Rd
Honolulu, HI 96819-1469
Mailing address
3288 Moanalua Rd
Honolulu, HI 96819-1469
Phone (808) 432-8121
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2219 | HI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277856000000",
"number": "1285778407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3288 MOANALUA RD",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968191469",
"telephone_number": "808-432-8121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3288 MOANALUA RD",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968191469",
"telephone_number": "808-432-8121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONG",
"first_name": "JACKSON",
"middle_name": "Z",
"name_prefix": "Dr.",
"credential": "PHARM.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-19",
"last_updated": "2010-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "HI",
"license": "2219",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Honolulu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.