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General NPI Number Information
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NPI Number | 1902343049
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Entity Type | Individual
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Provider Name | TINA MAI PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 01/27/2017
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Last Update Date | 01/27/2017
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Provider Practice Location Address
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Address Line | 3550 FRUITVALE AVE
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City | OAKLAND
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State | CA
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Zip | 94602-2327
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Country | US
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Telephone | 510-336-9305
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Fax | 510-336-9325
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Provider Business Mailing Address
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Address Line | 138 ORCHARD PARK PL
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City | HAYWARD
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State | CA
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Zip | 94544-1241
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Country | US
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Telephone | 510-499-3727
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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 | 76148
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License Number State | CA
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