Provider Demographics
NPI:1508390121
Name:EQUBAY, AYDA (PHARMD)
Entity Type:Individual
Prefix:
First Name:AYDA
Middle Name:
Last Name:EQUBAY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1319 HIGH ST
Mailing Address - Street 2:APT A
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-3167
Mailing Address - Country:US
Mailing Address - Phone:404-936-9388
Mailing Address - Fax:
Practice Address - Street 1:666 CONCAR DR
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-2622
Practice Address - Country:US
Practice Address - Phone:650-573-8551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-20
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA76349183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist