MEDICARE: DR. NAM HOAI DOAN DO 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	58851	CA

General Provider Information

NPI Number	:	1669523494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NAM HOAI DOAN DO PHARM.D.

Provider Business Mailing Address
First Line	:	3826 CARRERA CT
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95148-3716
Country	:	US
Telephone Number	:	415-309-9917
Fax Number	:	408-238-3978

Provider Business Practice Location Address
First Line	:	2060 ABORN RD
Second Line	:	#150-B
City	:	SAN JOSE
State	:	CA
Zip	:	95121-1584
Country	:	US
Telephone Number	:	408-238-3968
Fax Number	:	408-238-3978

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

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	07/08/2007

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