Provider Demographics
NPI:1245583772
Name:CHE, SAMIE
Entity Type:Individual
Prefix:
First Name:SAMIE
Middle Name:
Last Name:CHE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1459 TREAT BLVD
Mailing Address - Street 2:APT 618
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-7503
Mailing Address - Country:US
Mailing Address - Phone:818-795-8393
Mailing Address - Fax:
Practice Address - Street 1:1871 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-4106
Practice Address - Country:US
Practice Address - Phone:925-979-0095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-22
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA68331183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist