Individual provider Active NPI

Anh Phuong T Mitsuda, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Honolulu, HI
National Provider Identifier
1861900078
Registry record updated Jan 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
PH-2241 Issued in HI
Practice address
2750 Woodlawn Dr
Honolulu, HI 96822-1841
Phone
(808) 988-2151
NPI assigned
Jan 22, 2018
Last updated
Jan 22, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X PH-2241 HI Primary

Addresses

Primary practice location

2750 Woodlawn Dr
Honolulu, HI 96822-1841

Mailing address

2750 Woodlawn Dr
Honolulu, HI 96822-1841
Phone (808) 988-2151

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

LicenseStateTypeSpecialty
PH-2241HIMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1516579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516579200000",
    "number": "1861900078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 WOODLAWN DR",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968221841",
            "telephone_number": "808-988-2151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 WOODLAWN DR",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968221841",
            "telephone_number": "808-988-2151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITSUDA",
        "first_name": "ANH PHUONG",
        "middle_name": "T",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-22",
        "last_updated": "2018-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "HI",
            "license": "PH-2241",
            "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 Jan 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.