Doctor Name: | JIMMY SO |
NPI Number: | 1124409982 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 1459 Mainst Ramona, CA - 92065 |
Business Phone Number: | 7607890094 |
Business Fax Number: | |
Mailing Address: | 1459 Main St, RAMONA |
State: | CA |
Postal Code: | 920652128 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/17/2015 |
NPI Last Update Date: | 06/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 183700000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Pharmacy Service Providers |
Taxonomy Classification: | Pharmacy Technician |
Taxonomy Specialization: | |
Taxonomy Definition: | A person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professional judgment of a pharmacist. |