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NPI Code Detail

MEDICARE: MR. JON K IZUMI PHARMD

MEDICARE: MR. JON K IZUMI 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
1183500000XPharmacist51892CA

General Provider Information

NPI Number : 1659651396
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JON K IZUMI PHARMD
Provider Business Mailing Address
First Line : 3521 DEL PASO RD
Second Line :
City : SACRAMENTO
State : CA
Zip : 95835-2800
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3521 DEL PASO RD
Second Line :
City : SACRAMENTO
State : CA
Zip : 95835-2800
Country : US
Telephone Number : 916-515-1866
Fax Number : 916-515-0746
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2011
Last Update Date : 08/25/2011

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