Provider Demographics
NPI:1497302822
Name:HER, DAO (PHARMD)
Entity Type:Individual
Prefix:
First Name:DAO
Middle Name:
Last Name:HER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:DAO
Other - Middle Name:
Other - Last Name:HER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:758 S ADLER AVE APT 101
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-4885
Mailing Address - Country:US
Mailing Address - Phone:404-839-4247
Mailing Address - Fax:
Practice Address - Street 1:1113 E CHAMPLAIN DR
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-4223
Practice Address - Country:US
Practice Address - Phone:559-434-2158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-21
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80645183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist