Provider Demographics
NPI:1548561715
Name:TAKAHASHI, ALBERT YUKIMASA I (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:YUKIMASA
Last Name:TAKAHASHI
Suffix:I
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1663 BRANHAM LN
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95118-2200
Mailing Address - Country:US
Mailing Address - Phone:408-267-4942
Mailing Address - Fax:408-267-7347
Practice Address - Street 1:1663 BRANHAM LN
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95118-2200
Practice Address - Country:US
Practice Address - Phone:408-267-4942
Practice Address - Fax:408-267-7347
Is Sole Proprietor?:No
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist