Healthcare Provider Details

I. General information

NPI: 1164824116
Provider Name (Legal Business Name): WILLIAM THOMAS MOY PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2014
Last Update Date: 01/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 PASTEUR DR H0301, M/C 5616
STANFORD CA
94305-2200
US

IV. Provider business mailing address

300 PASTEUR DR H0301, M/C 5616
STANFORD CA
94305-2200
US

V. Phone/Fax

Practice location:
  • Phone: 650-725-5205
  • Fax:
Mailing address:
  • Phone: 650-725-5205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number58749
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: