1164683280 NPI number — DR. SONJA KAUBISCH PHARMD

Table of content: DR. SONJA KAUBISCH PHARMD (NPI 1164683280)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164683280 NPI number — DR. SONJA KAUBISCH PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KAUBISCH
Provider First Name:
SONJA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164683280
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
751 S BASCOM AVE
Provider Second Line Business Mailing Address:
DEPARTMENT OF PHARMACY
Provider Business Mailing Address City Name:
SAN JOSE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95128-2604
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-885-2300
Provider Business Mailing Address Fax Number:
408-885-5822

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1620 E CAPITOL EXPY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN JOSE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95121-1860
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-494-7507
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/20/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1835P0018X , with the licence number:  41794 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)