Healthcare Provider Details

I. General information

NPI: 1205811726
Provider Name (Legal Business Name): DANNY VERA PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/07/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 17TH ST
MODESTO CA
95354-1209
US

IV. Provider business mailing address

4214 MADISON LN
TURLOCK CA
95382-7319
US

V. Phone/Fax

Practice location:
  • Phone: 209-549-4018
  • Fax:
Mailing address:
  • Phone: 209-667-4188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number52735
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: