Healthcare Provider Details

I. General information

NPI: 1316292998
Provider Name (Legal Business Name): CLEMENT TOH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2012
Last Update Date: 07/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 DEER VALLEY RD
ANTIOCH CA
94531-8577
US

IV. Provider business mailing address

3170 OAK RD APT. #318
WALNUT CREEK CA
94597-7728
US

V. Phone/Fax

Practice location:
  • Phone: 925-813-6500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number63157
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: