MEDICARE: MARY NGAI 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	183500000X	Pharmacist	49563	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	49563	OTHER	CA	CALIFORNIA BOARD OF PHARMACY

General Provider Information

NPI Number	:	1649555954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY NGAI PHARM.D

Provider Business Mailing Address
First Line	:	200 W PORTAL AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94127-1423
Country	:	US
Telephone Number	:	415-665-1008
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 W PORTAL AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94127-1423
Country	:	US
Telephone Number	:	415-665-1008
Fax Number	:

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

Provider Enumeration Date	:	10/18/2011
Last Update Date	:	10/18/2011

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