Provider Demographics
NPI:1376101873
Name:NEMOTO, CHRISTIE H (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:H
Last Name:NEMOTO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:CHRISTIE
Other - Middle Name:H
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1530 SOUTHWEST EXPY APT 221
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-3990
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:777 E SANTA CLARA ST STE 300
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-1934
Practice Address - Country:US
Practice Address - Phone:808-977-8765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-31
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA751421835G0303X, 1835P2201X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care