Healthcare Provider Details

I. General information

NPI: 1659607786
Provider Name (Legal Business Name): DHARMA IRUTHYARAJ AROKIADASS R.PH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2009
Last Update Date: 10/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 SOLANO AVE
VALLEJO CA
94590-6456
US

IV. Provider business mailing address

1739 PINE ST # 11
SAN FRANCISCO CA
94109-4574
US

V. Phone/Fax

Practice location:
  • Phone: 707-552-1476
  • Fax:
Mailing address:
  • Phone: 415-272-7089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH 62344
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: