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General NPI Number Information
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NPI Number | 1902616279
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Entity Type | Organization
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Legal Business Name | NORTH EAST MEDICAL SERVICES
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Dates
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Enumeration Date | 01/09/2025
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 939 STORY RD
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City | SAN JOSE
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State | CA
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Zip | 95122-2688
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Country | US
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Telephone | 408-573-9686
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Fax |
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Provider Business Mailing Address
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Address Line | 2171 JUNIPERO SERRA BLVD STE 700
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City | DALY CITY
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State | CA
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Zip | 94014-1982
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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 | PRESIDENT & CEO
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Name | EDDIE W CHAN
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Credential |
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Telephone | 415-391-9686
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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