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General NPI Number Information
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NPI Number | 1396297420
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Entity Type | Individual
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Provider Name | DR. GONG YIE CAI
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Gender | Male
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Dates
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Enumeration Date | 10/24/2016
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Last Update Date | 10/24/2016
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Provider Practice Location Address
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Address Line | 4300 SONOMA BLVD
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City | VALLEJO
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State | CA
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Zip | 94589-2200
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Country | US
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Telephone | 707-642-2284
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Fax |
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Provider Business Mailing Address
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Address Line | 3663 SOLANO AVE APT 13
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City | NAPA
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State | CA
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Zip | 94558-2767
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Country | US
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Telephone | 626-217-7348
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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 | 75276
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License Number State | CA
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