Provider Demographics
NPI:1467133462
Name:BERHANE, BINIAM (PHARMD)
Entity Type:Individual
Prefix:
First Name:BINIAM
Middle Name:
Last Name:BERHANE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:BINIAM
Other - Middle Name:GEBREYESUS
Other - Last Name:BERHANE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2825 CAPITOL AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-6039
Mailing Address - Country:US
Mailing Address - Phone:916-887-0350
Mailing Address - Fax:
Practice Address - Street 1:2825 CAPITOL AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-6039
Practice Address - Country:US
Practice Address - Phone:916-887-0350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA71532441835C0205X
CA31555561835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835C0205XPharmacy Service ProvidersPharmacistCritical Care
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy