Provider Demographics
NPI:1356004543
Name:KLAG, JAMES WESTON (PHARMD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:WESTON
Last Name:KLAG
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 1:80 VASCO CT
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-4302
Mailing Address - Country:US
Mailing Address - Phone:415-637-1679
Mailing Address - Fax:
Practice Address - Street 1:7710 FIRST PL
Practice Address - Street 2:
Practice Address - City:OAKWOOD VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44146-6717
Practice Address - Country:US
Practice Address - Phone:440-735-0368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-15
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH034401871835N0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835N0905XPharmacy Service ProvidersPharmacistNuclear