Healthcare Provider Details

I. General information

NPI: 1285046185
Provider Name (Legal Business Name): MICHAEL UREDA PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2014
Last Update Date: 05/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 SOSCOL AVE
NAPA CA
94559-4007
US

IV. Provider business mailing address

217 SOSCOL AVE
NAPA CA
94559-4007
US

V. Phone/Fax

Practice location:
  • Phone: 707-224-1269
  • Fax: 707-224-1169
Mailing address:
  • Phone: 707-224-1269
  • Fax: 707-224-1169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH 30933
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: