Healthcare Provider Details

I. General information

NPI: 1811244486
Provider Name (Legal Business Name): COMMON COMPOUNDS CALIFORNIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2012
Last Update Date: 08/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3669 VIRGIN ISLANDS CT
PLEASANTON CA
94588-5228
US

IV. Provider business mailing address

3669 VIRGIN ISLANDS CT
PLEASANTON CA
94588-5228
US

V. Phone/Fax

Practice location:
  • Phone: 925-249-9328
  • Fax: 877-466-0288
Mailing address:
  • Phone: 925-249-9328
  • Fax: 877-466-0288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MRS. ROXANNE MARIE CECOT
Title or Position: OWNER
Credential:
Phone: 925-413-2721