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General NPI Number Information
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NPI Number | 1003434804
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Entity Type | Individual
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Provider Name | TIFFANY HO PHARMD
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Gender | Female
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Dates
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Enumeration Date | 07/08/2020
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Last Update Date | 07/30/2020
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Provider Practice Location Address
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Address Line | 200 MUIR RD
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City | MARTINEZ
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State | CA
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Zip | 94553-4614
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Country | US
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Telephone | 408-598-0507
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Fax |
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Provider Business Mailing Address
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Address Line | 1099 ROY FRERICHS LN
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City | TRACY
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State | CA
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Zip | 95377-6605
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Country | US
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Telephone | 408-598-0507
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Fax |
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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 | 82735
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License Number State | CA
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