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NPI Code Detail

MEDICARE: MANUEL BRAVO PHARMD

MEDICARE: MANUEL BRAVO PHARMD
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
1183500000XPharmacist61282CA

General Provider Information

NPI Number : 1366767402
Entity Type Code : Individual
Provider Name (Legal Business Name) : MANUEL BRAVO PHARMD
Provider Business Mailing Address
First Line : 1979 MISSION ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94103-3404
Country : US
Telephone Number : 415-558-8749
Fax Number : 415-558-8729
Provider Business Practice Location Address
First Line : 1363 DIVISADERO ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94115-3912
Country : US
Telephone Number : 415-931-9974
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2010
Last Update Date : 12/20/2022

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Directions to “ MANUEL BRAVO PHARMD” Practice Location

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