Healthcare Provider Details
I. General information
NPI: 1720556053
Provider Name (Legal Business Name): ACCESS OAKTOWN INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/05/2018
Last Update Date: 11/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2693 FRUITVALE AVE
OAKLAND CA
94601-2034
US
IV. Provider business mailing address
2693 FRUITVALE AVE
OAKLAND CA
94601-2034
US
V. Phone/Fax
- Phone: 510-330-4906
- Fax: 510-330-4902
- Phone: 510-330-4906
- Fax: 510-330-4902
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
DANIEL
F.
TORBATI
Title or Position: PRESIDENT/PIC
Credential:
Phone: 510-330-4906