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General NPI Number Information
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NPI Number | 1265835987
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Entity Type | Organization
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Legal Business Name | SOHUMTECH INC
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Dates
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Enumeration Date | 10/08/2014
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Last Update Date | 10/08/2014
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Provider Practice Location Address
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Address Line | 5438 SHATTUCK AVE
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City | FREMONT
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State | CA
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Zip | 94555-2931
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Country | US
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Telephone | 510-449-8032
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Fax |
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Provider Business Mailing Address
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Address Line | 5438 SHATTUCK AVE
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City | FREMONT
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State | CA
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Zip | 94555-2931
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Country | US
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Telephone | 510-449-8032
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Fax |
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Authorized Official
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Title or Position | GERIATRIC/MTM PHARMACIST
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Name | DR. PRITI MAJALI MAKANI
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Credential | PHARMD
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Telephone | 510-449-8032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | 56470
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 56470
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License Number State | CA
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