Healthcare Provider Details

I. General information

NPI: 1588370886
Provider Name (Legal Business Name): SALLY MEI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2023
Last Update Date: 01/30/2023
Certification Date: 01/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 OAKDALE RD
MODESTO CA
95355-3357
US

IV. Provider business mailing address

525 N 7TH ST UNIT 439
SAN JOSE CA
95112-7262
US

V. Phone/Fax

Practice location:
  • Phone: 773-344-1899
  • Fax:
Mailing address:
  • Phone: 773-344-1899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number051304391
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: