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Organization
CVS
Active
Organization
CVS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK TADAO TAMURA PHARMD (PHARMACIST)
(209) 712-7055
Entity
Organization
Contact information
Practice address
100 W LODI AVE, LODI, CA 95240-3517
(209) 369-3648
(209) 369-3104
Mailing address
11181 BOESSOW RD, GALT, CA 95632-8321
(209) 369-3648
(209) 369-3104
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
40586
CA
Other
Enumeration date
11/03/2015
Last updated
11/03/2015
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