MEDICARE: DR. SYLVIA TA PHARMD

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 50924	CA

General Provider Information

NPI Number	:	1336531193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SYLVIA TA PHARMD

Provider Business Mailing Address
First Line	:	PO BOX 21642
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93390-1642
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 24TH ST STE B120
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93301-2382
Country	:	US
Telephone Number	:	661-323-7006
Fax Number	:

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

Provider Enumeration Date	:	03/03/2015
Last Update Date	:	03/03/2015

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