MEDICARE: DAVID E HEBERT PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	RPH 35413	CA

General Provider Information

NPI Number	:	1154661676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID E HEBERT PHARM.D.

Provider Business Mailing Address
First Line	:	729 W SAN MADELE AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93704-2331
Country	:	US
Telephone Number	:	559-435-0478
Fax Number	:

Provider Business Practice Location Address
First Line	:	729 W SAN MADELE AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93704-2331
Country	:	US
Telephone Number	:	559-435-0478
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2013
Last Update Date	:	02/20/2013

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