Provider Demographics
NPI:1114201092
Name:MARSHALL, HUBERT (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:HUBERT
Middle Name:
Last Name:MARSHALL
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 1:164 W JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-1810
Mailing Address - Country:US
Mailing Address - Phone:510-781-0900
Mailing Address - Fax:510-781-4827
Practice Address - Street 1:164 W JACKSON ST
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94544-1810
Practice Address - Country:US
Practice Address - Phone:510-781-0900
Practice Address - Fax:510-781-4827
Is Sole Proprietor?:No
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55523183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist