Provider Demographics
NPI:1326550690
Name:OH, DANIEL HYUNG-SOK (PHARMD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:HYUNG-SOK
Last Name:OH
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 1:14822 E 14TH ST APT 308
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-2934
Mailing Address - Country:US
Mailing Address - Phone:650-522-0037
Mailing Address - Fax:
Practice Address - Street 1:615 BROADWAY
Practice Address - Street 2:
Practice Address - City:MILLBRAE
Practice Address - State:CA
Practice Address - Zip Code:94030-1909
Practice Address - Country:US
Practice Address - Phone:650-697-0166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-26
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA77707183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist