Healthcare Provider Details

I. General information

NPI: 1982638573
Provider Name (Legal Business Name): ROYAL MEDICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 08/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2929 TELEGRAPH AVE
BERKELEY CA
94705-2017
US

IV. Provider business mailing address

2929 TELEGRAPH AVE
BERKELEY CA
94705-2017
US

V. Phone/Fax

Practice location:
  • Phone: 510-843-3201
  • Fax: 510-843-0308
Mailing address:
  • Phone: 510-843-3201
  • Fax: 510-843-0308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHA415390
License Number StateCA

VIII. Authorized Official

Name: DR. DR-PAM GUMBS
Title or Position: CEO, CLINICAL AFFAIRS
Credential: PHARM D.
Phone: 510-843-3201