Healthcare Provider Details

I. General information

NPI: 1194993006
Provider Name (Legal Business Name): DANIEL B. DONG PHARM. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2008
Last Update Date: 02/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 CATHERINE DR
BERKELEY CA
94702-1219
US

IV. Provider business mailing address

1460 CATHERINE DR
BERKELEY CA
94702-1219
US

V. Phone/Fax

Practice location:
  • Phone: 510-816-0054
  • Fax:
Mailing address:
  • Phone: 510-816-0054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number33295
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: