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General NPI Number Information
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NPI Number | 1114083482
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Entity Type | Organization
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Legal Business Name | ALAMEDA HEALTH SYSTEM
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 09/13/2016
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Provider Practice Location Address
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Address Line | 2060 FAIRMONT DR
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City | SAN LEANDRO
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State | CA
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Zip | 94578-1001
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Country | US
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Telephone | 510-346-1454
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Fax | 510-614-9516
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Provider Business Mailing Address
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Address Line | 2060 FAIRMONT DR
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City | SAN LEANDRO
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State | CA
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Zip | 94578-1001
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Country | US
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Telephone | 510-346-1454
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Fax | 510-614-9516
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Authorized Official
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Title or Position | DIR OF PHCY
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Name | MARTHA YASAVOLIAN
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Credential |
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Telephone | 510-437-5055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number | HPE37659
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License Number State | CA
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