Provider Demographics
NPI:1518491315
Name:DO, AMBER (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMBER
Middle Name:
Last Name:DO
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 1:3035 GAYWOOD CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-2629
Mailing Address - Country:US
Mailing Address - Phone:408-972-6349
Mailing Address - Fax:408-972-6295
Practice Address - Street 1:3035 GAYWOOD CT
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95148-2629
Practice Address - Country:US
Practice Address - Phone:408-972-6349
Practice Address - Fax:408-972-6295
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-18
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52753183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist