Organization
FRUITVALE MEDICAL CENTER PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KUO LIANG YANG (PHARMACIST OWNER)
(510) 535-1005
Entity
Organization
Contact information
Practice address
3024 INTERNATIONAL BLVD, OAKLAND, CA 94601-2204
(510) 535-1005
(510) 535-9374
Mailing address
3024 INTERNATIONAL BLVD, OAKLAND, CA 94601-2204
(510) 535-1005
(510) 535-9374
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHY35207
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0594538
ALAMEDA ALLIANCE
CA
Enumeration date
11/02/2005
Last updated
07/11/2008
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