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General NPI Number Information
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NPI Number | 1154384345
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Entity Type | Individual
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Provider Name | KAY RAYMOND NIEGEL RPH
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Gender | Male
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Dates
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Enumeration Date | 04/10/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4725 QUAIL LAKES DR
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City | STOCKTON
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State | CA
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Zip | 95207-5243
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Country | US
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Telephone | 209-952-3599
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Fax | 209-952-3636
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Provider Business Mailing Address
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Address Line | 3731 HATCHERS CIR
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City | STOCKTON
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State | CA
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Zip | 95219-3129
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Country | US
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Telephone | 209-951-2890
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Fax | 209-952-3636
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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 | 26140
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License Number State | CA
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