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General NPI Number Information
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NPI Number | 1952653958
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Entity Type | Individual
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Provider Name | SUDA PAUL
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Gender | Female
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Dates
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Enumeration Date | 10/15/2012
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Last Update Date | 10/15/2012
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Provider Practice Location Address
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Address Line | 3116 JO ANN DR
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City | RICHMOND
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State | CA
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Zip | 94806-2723
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Country | US
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Telephone | 925-788-1149
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Fax |
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Provider Business Mailing Address
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Address Line | 31 VALENCIA RD
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City | ORINDA
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State | CA
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Zip | 94563-4135
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Country | US
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Telephone | 925-788-1149
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Fax | 925-376-5165
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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 | 38346
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License Number State | CA
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