Healthcare Provider Details

I. General information

NPI: 1093528341
Provider Name (Legal Business Name): NEW GOLDEN GATE PHARMA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2025
Last Update Date: 01/30/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 IRVING ST
SAN FRANCISCO CA
94122
US

IV. Provider business mailing address

801 IRVING ST
SAN FRANCISCO CA
94122
US

V. Phone/Fax

Practice location:
  • Phone: 415-664-8800
  • Fax: 415-664-8518
Mailing address:
  • Phone: 415-664-8800
  • Fax: 415-664-8518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: IQBAL S GILL
Title or Position: OWNER/MANAGER
Credential: RPH
Phone: 510-938-2477