Healthcare Provider Details

I. General information

NPI: 1376502559
Provider Name (Legal Business Name): LINDA C CHAN PHARMTECH
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 HOLLOWAY AVE STUDENT HEALTH SERVICES SAN FRANCISCO STATE UNIVERSITY
SAN FRANCISCO CA
94132-4200
US

IV. Provider business mailing address

1600 HOLLOWAY AVE STUDENT HEALTH SERVICES SAN FRANCISCO STATE UNIVERSITY
SAN FRANCISCO CA
94132-4200
US

V. Phone/Fax

Practice location:
  • Phone: 415-338-1351
  • Fax: 415-338-6834
Mailing address:
  • Phone: 415-338-1351
  • Fax: 415-338-6834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number47886
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: