Provider Demographics
NPI:1134108160
Name:WATAOKA, TODD S (PHARMD, CDE)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:S
Last Name:WATAOKA
Suffix:
Gender:M
Credentials:PHARMD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 JARRETT WHITE RD
Mailing Address - Street 2:TAMC-DEPT OF PHARMACY
Mailing Address - City:TRIPLER ARMY MEDICAL CENTER
Mailing Address - State:HI
Mailing Address - Zip Code:96859-5001
Mailing Address - Country:US
Mailing Address - Phone:808-433-2989
Mailing Address - Fax:
Practice Address - Street 1:TRIPLER ARMY MEDICAL CENTER, DEPT OF PHARMACY
Practice Address - Street 2:1 JARRETT WHITE ROAD
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96859-5000
Practice Address - Country:US
Practice Address - Phone:808-433-2989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1491183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist