Healthcare Provider Details

I. General information

NPI: 1124502083
Provider Name (Legal Business Name): KYMBERLI SUZANNE BUYER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2018
Last Update Date: 09/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1449 E F ST
OAKDALE CA
95361-9265
US

IV. Provider business mailing address

4220 MILTON WAY
LIVERMORE CA
94551-4823
US

V. Phone/Fax

Practice location:
  • Phone: 209-847-4279
  • Fax:
Mailing address:
  • Phone: 925-518-4739
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number78886
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: