Healthcare Provider Details

I. General information

NPI: 1992018246
Provider Name (Legal Business Name): ELHAM SENEMAR PHARMACIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2010
Last Update Date: 07/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1997 TICE VALLEY BLVD
WALNUT CREEK CA
94595-2201
US

IV. Provider business mailing address

4515 KINGSWOOD DR
DANVILLE CA
94506-6034
US

V. Phone/Fax

Practice location:
  • Phone: 925-932-0568
  • Fax: 925-932-0335
Mailing address:
  • Phone: 925-648-9193
  • Fax: 925-648-9295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number46097
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: