Provider Demographics
NPI:1376686089
Name:DONALD B. FOX
Entity Type:Organization
Organization Name:DONALD B. FOX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:BLAIR
Authorized Official - Last Name:FOX
Authorized Official - Suffix:SR
Authorized Official - Credentials:RPH
Authorized Official - Phone:925-685-0147
Mailing Address - Street 1:2100 MONUMENT BLVD STE 20
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-3400
Mailing Address - Country:US
Mailing Address - Phone:925-685-0147
Mailing Address - Fax:925-685-0308
Practice Address - Street 1:2100 MONUMENT BLVD STE 20
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-3400
Practice Address - Country:US
Practice Address - Phone:925-685-0147
Practice Address - Fax:925-685-0308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA275183336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0540939OtherNCPDP #
CAPHA194910Medicaid
CAAM7463285OtherDEA
CAPHA194910Medicaid