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General NPI Number Information
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NPI Number | 1467373647
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Entity Type | Individual
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Provider Name | LAURA KATHLEEN FORMOSA PHARMD, RPH
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Gender | Female
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Dates
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Enumeration Date | 07/23/2026
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Last Update Date | 07/23/2026
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Provider Practice Location Address
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Address Line | 710 LAWRENCE EXPY
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City | SANTA CLARA
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State | CA
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Zip | 95051-5173
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Country | US
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Telephone | 408-851-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 25 S 3RD ST UNIT 503
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City | SAN JOSE
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State | CA
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Zip | 95113-2520
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Country | US
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Telephone |
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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 | RPH91629
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License Number State | CA
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