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General NPI Number Information
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NPI Number | 1235384132
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Entity Type | Individual
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Provider Name | MICHAEL ABRAHAM GEBRU PHARM D.
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Gender | Male
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Dates
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Enumeration Date | 11/20/2008
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Last Update Date | 04/20/2022
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Provider Practice Location Address
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Address Line | 2447 TELEGRAPH AVE
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City | OAKLAND
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State | CA
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Zip | 94612-2404
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Country | US
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Telephone | 510-984-1429
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Fax | 510-646-9840
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Provider Business Mailing Address
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Address Line | 5460 SAN MARTIN WAY
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City | ANTIOCH
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State | CA
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Zip | 94531-8506
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Country | US
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Telephone | 213-840-2931
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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 | 60380
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License Number State | CA
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