Healthcare Provider Details

I. General information

NPI: 1881258259
Provider Name (Legal Business Name): JACK M ARBEED PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2019
Last Update Date: 04/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 SIR FRANCIS DRAKE BLVD
SAN ANSELMO CA
94960-1914
US

IV. Provider business mailing address

75 FOLSOM ST APT 1105
SAN FRANCISCO CA
94105-6103
US

V. Phone/Fax

Practice location:
  • Phone: 415-456-9900
  • Fax: 415-456-3953
Mailing address:
  • Phone: 650-430-3759
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number29037
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: