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General NPI Number Information
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NPI Number | 1942863493
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Entity Type | Individual
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Provider Name | MAKDA GEBREHIWET PHARMD
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Gender | Female
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Dates
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Enumeration Date | 04/19/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 670 EL CERRITO PLZ
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City | EL CERRITO
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State | CA
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Zip | 94530-4010
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Country | US
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Telephone | 510-524-5895
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Fax |
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Provider Business Mailing Address
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Address Line | 130 SHORELINE CIR APT 475
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City | SAN RAMON
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State | CA
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Zip | 94582-5094
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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 |
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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 | 77644
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License Number State | CA
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