Provider Demographics
NPI:1114404712
Name:YOSHIZUKA, KEITH ISAMU (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:ISAMU
Last Name:YOSHIZUKA
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 1:1310 CLUB DRIVE
Mailing Address - Street 2:TOURO UNIVERSITY CALIFORNIA COLLEGE OF PHARMACY
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94592
Mailing Address - Country:US
Mailing Address - Phone:707-638-5992
Mailing Address - Fax:707-638-5953
Practice Address - Street 1:1310 CLUB DRIVE
Practice Address - Street 2:TOURO UNIVERSITY CALIFORNIA COLLEGE OF PHARMACY
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94592
Practice Address - Country:US
Practice Address - Phone:707-638-5992
Practice Address - Fax:707-638-5953
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-26
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30125183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist