Healthcare Provider Details

I. General information

NPI: 1801127659
Provider Name (Legal Business Name): VIKAS BAJAJ RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2010
Last Update Date: 01/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 N VASCO RD
LIVERMORE CA
94551-9212
US

IV. Provider business mailing address

1350 NORTH VASCO ROAD
LIVERMORE CA
94551-0000
US

V. Phone/Fax

Practice location:
  • Phone: 925-243-1702
  • Fax: 925-243-1713
Mailing address:
  • Phone: 925-243-1702
  • Fax: 925-243-1713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number60672
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: