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General NPI Number Information
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NPI Number | 1811669963
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Entity Type | Individual
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Provider Name | HAMED TABEEFAR
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Gender | Male
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Dates
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Enumeration Date | 09/28/2021
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Last Update Date | 08/16/2022
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Provider Practice Location Address
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Address Line | 975 SERENO DR
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City | VALLEJO
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State | CA
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Zip | 94589-2441
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Country | US
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Telephone | 650-665-3034
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Fax |
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Provider Business Mailing Address
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Address Line | 10 SERRA CT
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City | NOVATO
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State | CA
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Zip | 94949-6150
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Country | US
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Telephone | 650-665-3034
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 81506
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License Number State | CA
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