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General NPI Number Information
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NPI Number | 1821123456
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Entity Type | Organization
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Legal Business Name | OAK GROVE PHARMACY
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 785 OAK GROVE RD STE G2
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City | CONCORD
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State | CA
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Zip | 94518-3605
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Country | US
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Telephone | 925-681-1823
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Fax | 925-681-1827
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Provider Business Mailing Address
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Address Line | 785 OAK GROVE RD G2
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City | CONCORD
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State | CA
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Zip | 94518-3615
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Country | US
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Telephone | 925-681-1823
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Fax | 925-681-1827
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Authorized Official
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Title or Position | OWNER
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Name | DR. NASER KALIL
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Credential | PHARMD
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Telephone | 925-681-1823
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PHA43276
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License Number State | CA
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