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MATTHEW R CHAO
>> Pharmacist >> Pharmacy Service ProvidersRegistrant NPI Number: 1831799345
Individual Registrant: MATTHEW R CHAO
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
455 CENTER ST HEALDSBURG, CA 95448-3807 US
Tel: 707-433-3357 Fax: --
Tel: 707-433-3357 Fax: --
Contact information for business:
4145 SHADOW LN APT 527 SANTA ROSA, CA 95405-5255 US
Tel: 510-825-5708 Fax: --
Tel: 510-825-5708 Fax: --
Registration Information:
NPI: 1831799345
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 183500000X | Pharmacy Service Providers Pharmacist | CA | 83011 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
