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General NPI Number Information
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NPI Number | 1023381647
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Entity Type | Individual
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Provider Name | KANDIE ANN RAGO RPH
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Gender | Female
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Dates
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Enumeration Date | 02/13/2012
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Last Update Date | 03/08/2021
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Provider Practice Location Address
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Address Line | 4020 FREMONT HUB
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City | FREMONT
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State | CA
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Zip | 94538-1322
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Country | US
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Telephone | 510-791-9108
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Fax |
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Provider Business Mailing Address
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Address Line | 6332 JARVIS AVE
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City | NEWARK
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State | CA
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Zip | 94560-1246
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Country | US
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Telephone | 209-322-5597
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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 | 65744
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License Number State | CA
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