Provider Demographics
NPI:1003692740
Name:KO, RICHARD JAMES WEI HSIN (PHARMD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:JAMES WEI HSIN
Last Name:KO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 751
Mailing Address - Street 2:
Mailing Address - City:PINOLE
Mailing Address - State:CA
Mailing Address - Zip Code:94564-0751
Mailing Address - Country:US
Mailing Address - Phone:510-972-8627
Mailing Address - Fax:
Practice Address - Street 1:508 ATHENA APT 5
Practice Address - Street 2:
Practice Address - City:HERCULES
Practice Address - State:CA
Practice Address - Zip Code:94547-1947
Practice Address - Country:US
Practice Address - Phone:510-972-8627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV09222183500000X
CARPH40222183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist