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NPI Code Detail

MEDICARE: TONY G BASTIAN PHARMACY INC.

MEDICARE: TONY G BASTIAN PHARMACY 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
1333600000XPharmacyPHY32668CA
23336C0003XCommunity/Retail PharmacyPHY32668CA

General Provider Information

NPI Number : 1730231895
Entity Type Code : Organization
Provider Name (Legal Business Name) : TONY G BASTIAN PHARMACY INC.
Provider Business Mailing Address
First Line : 5199 GEARY BLVD
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94118-2815
Country : US
Telephone Number : 415-751-2326
Fax Number : 415-751-2328
Provider Business Practice Location Address
First Line : 5199 GEARY BLVD
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94118-2815
Country : US
Telephone Number : 415-751-2326
Fax Number : 415-751-2328
Authorized Official
Title or Position : PRESIDENT
Name : MR. TONY G BASTIAN
Credential : RPH
Telephone Number : 415-751-2326
Provider Enumeration Date : 01/17/2007
Last Update Date : 10/25/2012

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