Provider Information for 1629391602
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BAYPHARMACY II A PROFESSIONAL CORP
Other Names:Doing Business As:BAY PHARMACYOrganization Subpart: NO
NPI: 1629391602
Last Updated: 2016-08-10
Certification Date:
Certification Date:
Details
Name | Value | ||||||||||||
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NPI | 1629391602 | ||||||||||||
Enumeration Date | 2010-03-05 | ||||||||||||
NPI Type | NPI-2 Organization | ||||||||||||
Status | Active | ||||||||||||
Authorized Official Information | Name: BAY NGUYEN Title: PRESIDENT Phone: 4082230180 | ||||||||||||
Mailing Address | 1661 BURDETTE DR STE AB SAN JOSE, CA 95121-1613 United States Phone: 408-223-0180 | Fax:408-223-2366 | ||||||||||||
Primary Practice Address | 1661 BURDETTE DR STE AB SAN JOSE, CA 95121-1613 United States Phone: 408-223-0180 | Fax:408-223-2366 | ||||||||||||
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