Healthcare Provider Details
I. General information
NPI: 1528540838
Provider Name (Legal Business Name): THE WEST OAKLAND HEALTH COUNCIL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/04/2018
Last Update Date: 09/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7450 INTERNATIONAL BLVD
OAKLAND CA
94621-2806
US
IV. Provider business mailing address
700 ADELINE ST
OAKLAND CA
94607-2608
US
V. Phone/Fax
- Phone: 510-835-9610
- Fax: 510-836-7799
- Phone: 510-835-9610
- Fax: 510-836-7799
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0002X |
| Taxonomy | Clinic Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
P
MCCABE
Title or Position: DIRECTOR OF PHARMACY SERVICES
Credential: RPH
Phone: 510-835-9610