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NPI Code Detail

MEDICARE: ROYAL MEDICAL INC.

MEDICARE: ROYAL MEDICAL INC.
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
1333600000XPharmacy0600026208CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578571030
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROYAL MEDICAL INC.
Provider Business Mailing Address
First Line : 2929 TELEGRAPH AVE
Second Line :
City : BERKELEY
State : CA
Zip : 94705-2017
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2929 TELEGRAPH AVE
Second Line :
City : BERKELEY
State : CA
Zip : 94705-2017
Country : US
Telephone Number : 510-540-0494
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MR. TENGIZ IOSEBASHVILI
Credential :
Telephone Number : 510-540-0494
Provider Enumeration Date : 08/03/2006
Last Update Date : 08/22/2020

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Directions to “ROYAL MEDICAL INC. ” Practice Location

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