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General NPI Number Information
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NPI Number | 1003068305
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Entity Type | Individual
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Provider Name | SUTTINEE SAGUANDEEKUL RPH
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Gender | Female
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Dates
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Enumeration Date | 10/17/2008
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Last Update Date | 10/17/2008
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Provider Practice Location Address
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Address Line | 910 DIABLO AVE
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City | NOVATO
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State | CA
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Zip | 94947
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Country | US
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Telephone | 415-898-1905
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Fax | 415-898-5121
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Provider Business Mailing Address
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Address Line | 82 QUEVA VIS
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City | NOVATO
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State | CA
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Zip | 94947-2109
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Country | US
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Telephone | 415-899-0154
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Fax | 415-899-0154
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH 38519
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License Number State | CA
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