Healthcare Provider Details

I. General information

NPI: 1003954751
Provider Name (Legal Business Name): NORMA MIYEKO MARUBAYASHI HOLLOWAY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 W MACARTHUR BLVD
OAKLAND CA
94611-5642
US

IV. Provider business mailing address

504 LINDELL LN
SAN RAMON CA
94582-1246
US

V. Phone/Fax

Practice location:
  • Phone: 510-752-6468
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH 38281
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: