Healthcare Provider Details

I. General information

NPI: 1922355742
Provider Name (Legal Business Name): ALBERT T BACH PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2012
Last Update Date: 06/15/2020
Certification Date: 06/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 E CHAPMAN AVE
ORANGE CA
92869-3204
US

IV. Provider business mailing address

9401 JERONIMO RD
IRVINE CA
92618-1908
US

V. Phone/Fax

Practice location:
  • Phone: 714-323-5150
  • Fax: 657-800-4272
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number67326
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number67326
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: