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NPI Code Detail

MEDICARE: LWAM ABRAHA

MEDICARE: LWAM ABRAHA
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
1183500000XPharmacist78183CA

General Provider Information

NPI Number : 1669953410
Entity Type Code : Individual
Provider Name (Legal Business Name) : LWAM ABRAHA
Provider Business Mailing Address
First Line : 1101 SAN RAMON VALLEY BLVD
Second Line :
City : DANVILLE
State : CA
Zip : 94526-4851
Country : US
Telephone Number : 571-882-4911
Fax Number :
Provider Business Practice Location Address
First Line : 611 SAN RAMON VALLEY BLVD
Second Line :
City : DANVILLE
State : CA
Zip : 94526-4013
Country : US
Telephone Number : 925-743-0166
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2018
Last Update Date : 08/28/2018

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Directions to “ LWAM ABRAHA ” Practice Location

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