Healthcare Provider Details

I. General information

NPI: 1639512973
Provider Name (Legal Business Name): VICTOR MOYE PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2013
Last Update Date: 04/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

395 HICKEY BLVD FL 2 SPECIALTY PHARMACY
DALY CITY CA
94015-2770
US

IV. Provider business mailing address

395 HICKEY BLVD FL 2 SPECIALTY PHARMACY
DALY CITY CA
94015-2770
US

V. Phone/Fax

Practice location:
  • Phone: 650-301-5799
  • Fax: 650-301-5790
Mailing address:
  • Phone: 650-301-5799
  • Fax: 650-301-5790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH43973
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: