Healthcare Provider Details

I. General information

NPI: 1265874747
Provider Name (Legal Business Name): PLEASANT CARE PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2013
Last Update Date: 07/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1652 B ST
HAYWARD CA
94541-3020
US

IV. Provider business mailing address

1652 B ST
HAYWARD CA
94541-3020
US

V. Phone/Fax

Practice location:
  • Phone: 510-200-9984
  • Fax: 888-453-7344
Mailing address:
  • Phone: 510-200-9984
  • Fax: 888-453-7344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. CHAU THANH PHAN
Title or Position: CEO
Credential: M.S., PHARMD
Phone: 510-200-9984