MEDICARE: JEANNIE M SOHN PHARM.D.

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
1	1835P1200X	Pharmacotherapy Pharmacist	36837	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A958953	OTHER	CA	NUID

General Provider Information

NPI Number	:	1528199577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANNIE M SOHN PHARM.D.

Provider Business Mailing Address
First Line	:	6573 MOUNT ROYAL DR
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95120-1937
Country	:	US
Telephone Number	:	650-299-2706
Fax Number	:	650-299-3821

Provider Business Practice Location Address
First Line	:	6573 MOUNT ROYAL DR
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95120-1937
Country	:	US
Telephone Number	:	650-299-2706
Fax Number	:	650-299-3821

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	07/08/2007

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