Organization
ORIENTAL TWIN DRAGONS LTD
Active
Other names
ESTUDILLO PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BILL HAM (SEC TRES)
(510) 483-5744
Entity
Organization
Contact information
Practice address
215 ESTUDILLO AVE, SAN LEANDRO, CA 94577-4721
(510) 483-5744
(510) 483-5785
Mailing address
215 ESTUDILLO AVE, SAN LEANDRO, CA 94577-4721
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY30804
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0580969
OTHER ID NUMBER
—
Enumeration date
01/30/2007
Last updated
12/05/2007
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