Healthcare Provider Details

I. General information

NPI: 1952210213
Provider Name (Legal Business Name): TYRANNIE CABLE RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5100 BROADWAY
OAKLAND CA
94611-4620
US

IV. Provider business mailing address

1596 E GATE WAY APT 216
PLEASANTON CA
94566-3541
US

V. Phone/Fax

Practice location:
  • Phone: 510-285-0790
  • Fax: 510-285-0785
Mailing address:
  • Phone: 925-719-5793
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number93080
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: