Healthcare Provider Details

I. General information

NPI: 1134750722
Provider Name (Legal Business Name): CYNTHIA KAWAMURA PHARMACY TECHNICIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2020
Last Update Date: 01/31/2020
Certification Date: 01/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

558 MORNINGHOME RD
DANVILLE CA
94526-3612
US

IV. Provider business mailing address

558 MORNINGHOME RD
DANVILLE CA
94526-3612
US

V. Phone/Fax

Practice location:
  • Phone: 925-389-6260
  • Fax:
Mailing address:
  • Phone: 925-389-6260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number109724
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: