Healthcare Provider Details

I. General information

NPI: 1205906773
Provider Name (Legal Business Name): KENNETH H CHEE PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 12/17/2021
Certification Date: 12/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 BICENTENNIAL WAY
SANTA ROSA CA
95403-2149
US

IV. Provider business mailing address

2512 HORSESHOE DR
SANTA ROSA CA
95405-8144
US

V. Phone/Fax

Practice location:
  • Phone: 707-483-9972
  • Fax:
Mailing address:
  • Phone: 707-236-0540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number43031
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: