Healthcare Provider Details

I. General information

NPI: 1316005788
Provider Name (Legal Business Name): MATTHEW CHARLES KIRKPATRICK PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 INTERNATIONAL CIR
SAN JOSE CA
95119-1130
US

IV. Provider business mailing address

1380 THUNDERBIRD AVE
SUNNYVALE CA
94087-3733
US

V. Phone/Fax

Practice location:
  • Phone: 408-972-3539
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number51397
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: