Organization
TRI-VALLEY PHARMACY CORPORATION
Active
Other names
STONERIDGE PROFESSIONAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN FONG PHARM.D. (PRESIDENT)
(925) 463-2248
Entity
Organization
Contact information
Practice address
5720 STONERIDGE MALL RD, #150, PLEASANTON, CA 94588-2828
(925) 463-2248
(925) 463-5615
Mailing address
5720 STONERIDGE MALL RD, #150, PLEASANTON, CA 94588-2828
(925) 463-2248
(925) 463-5615
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY47432
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2003041
PK
—
05
—
PHA222970
—
CA
Enumeration date
06/19/2006
Last updated
12/01/2016
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