Healthcare Provider Details

I. General information

NPI: 1285742890
Provider Name (Legal Business Name): DR. DAVID WEEKS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 BODIN CIRCLE BUILDING 778
TRAVIS AIR FORCE BASE CA
94535
US

IV. Provider business mailing address

253 EMILY ST
VALLEJO CA
94589-3203
US

V. Phone/Fax

Practice location:
  • Phone: 707-437-1820
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH 35433
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: