Healthcare Provider Details

I. General information

NPI: 1023483997
Provider Name (Legal Business Name): EILEEN BRIGID DOYLE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2015
Last Update Date: 12/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2187 SHATTUCK AVE
BERKELEY CA
94704-1308
US

IV. Provider business mailing address

2187 SHATTUCK AVE
BERKELEY CA
94704-1308
US

V. Phone/Fax

Practice location:
  • Phone: 510-982-3727
  • Fax: 510-982-3737
Mailing address:
  • Phone: 510-982-3727
  • Fax: 510-982-3737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number63386
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: