Healthcare Provider Details

I. General information

NPI: 1013272061
Provider Name (Legal Business Name): BONNIE FABIAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2012
Last Update Date: 12/27/2021
Certification Date: 12/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2238 GEARY BLVD 8TH FLOOR PHARMACY
SAN FRANCISCO CA
94115-3416
US

IV. Provider business mailing address

2238 GEARY BLVD FL 5
SAN FRANCISCO CA
94115-3416
US

V. Phone/Fax

Practice location:
  • Phone: 415-833-2865
  • Fax: 415-833-8860
Mailing address:
  • Phone: 415-833-0878
  • Fax: 415-833-3106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number65556
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number65556
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: