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General NPI Number Information
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NPI Number | 1750799797
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Entity Type | Organization
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Legal Business Name | NEW OAKLAND PHARMACY
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Dates
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Enumeration Date | 07/22/2014
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Last Update Date | 07/22/2014
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Provider Practice Location Address
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Address Line | 639 WATERFALL
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City | ALAMEDA
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State | CA
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Zip | 94501
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Country | US
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Telephone | 510-566-8828
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Fax |
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Provider Business Mailing Address
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Address Line | 639 WATERFALL ISLE
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City | ALAMEDA
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State | CA
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Zip | 94501-5647
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Country | US
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Telephone | 510-566-8828
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | BEN GENE LEONG
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Credential | PHARMD
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Telephone | 510-566-8828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 28454
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License Number State | CA
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