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NPI Code Detail

MEDICARE: TAMARA I. LIGHTFOOT RPH

MEDICARE:   TAMARA I. LIGHTFOOT  RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist45590CA

General Provider Information

NPI Number : 1235407354
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMARA I. LIGHTFOOT RPH
Provider Business Mailing Address
First Line : 965 GENEVA AVE
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94112-3423
Country : US
Telephone Number : 415-841-0507
Fax Number :
Provider Business Practice Location Address
First Line : 965 GENEVA AVE
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94112-3423
Country : US
Telephone Number : 415-841-0507
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2011
Last Update Date : 12/03/2011

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Directions to “ TAMARA I. LIGHTFOOT RPH” Practice Location

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