Individual
JOHNNY K THAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3600 BROADWAY, OAKLAND, CA 94611-5730
(510) 752-1000
Mailing address
3600 BROADWAY, OAKLAND, CA 94611-5730
(415) 203-5142
Taxonomy
Speciality
Code
Description
License number
State
1835P2201X
Ambulatory Care Pharmacist
Primary
79259
CA
Other
Enumeration date
12/05/2019
Last updated
12/17/2021
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