Healthcare Provider Details

I. General information

NPI: 1184760951
Provider Name (Legal Business Name): COMFORT CARE PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 9TH ST STE 315
OAKLAND CA
94607-4428
US

IV. Provider business mailing address

212 9TH ST STE 315
OAKLAND CA
94607-4428
US

V. Phone/Fax

Practice location:
  • Phone: 510-251-8836
  • Fax:
Mailing address:
  • Phone: 510-251-8836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberPHY48345
License Number StateCA

VIII. Authorized Official

Name: DR. LARRY CHAN
Title or Position: PRESIDENT
Credential: PHARM. D.
Phone: 510-251-8836