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Individual
MR. BAU TO
Active
Individual
MR. BAU TO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH40948
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0526662
WELLCARE HEALTH PLAN
CA
01
—
0526662
NCPDP
—
05
—
PHA412250
—
CA
01
—
PHY41225
STATE LICENSE
CA
Enumeration date
09/22/2006
Last updated
07/08/2007
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