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Individual

MR. BAU TO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
629 COOPER RD, OXNARD, CA 93030-5427
(805) 483-1121
(805) 483-1121
Mailing address
629 COOPER RD, OXNARD, CA 93030-5427
(805) 483-1121
(805) 483-1121

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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