Healthcare Provider Details

I. General information

NPI: 1669710604
Provider Name (Legal Business Name): VIDHU OHRI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2013
Last Update Date: 02/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4380 SAN JUAN AVE
FREMONT CA
94536-4736
US

IV. Provider business mailing address

35640 FREMONT BLVD # 420
FREMONT CA
94536-3420
US

V. Phone/Fax

Practice location:
  • Phone: 408-230-6145
  • Fax:
Mailing address:
  • Phone: 510-585-3657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number59322
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: