Healthcare Provider Details
I. General information
NPI: 1508601246
Provider Name (Legal Business Name): DAVID DAKWA PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/26/2024
Last Update Date: 06/26/2024
Certification Date: 06/25/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2315 STOCKTON BLVD
SACRAMENTO CA
95817-2201
US
IV. Provider business mailing address
3153 FINCH LN
WEST SACRAMENTO CA
95691-6434
US
V. Phone/Fax
- Phone: 916-734-1426
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1835P1200X |
| Taxonomy | Pharmacotherapy Pharmacist |
| License Number | 82271 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: