Healthcare Provider Details

I. General information

NPI: 1174741326
Provider Name (Legal Business Name): MATTHEW CHANDLER PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 EL CAMINO REAL
SOUTH SAN FRANCISCO CA
94080-3208
US

IV. Provider business mailing address

1576 GREAT HWY APT 201
SAN FRANCISCO CA
94122-2821
US

V. Phone/Fax

Practice location:
  • Phone: 650-742-2486
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number59159
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: