Provider Demographics
NPI:1578930061
Name:OBER, JAMES THEODORE (PHARMD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:THEODORE
Last Name:OBER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 GOLF COURSE DR
Mailing Address - Street 2:
Mailing Address - City:ROHNERT PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94928-1800
Mailing Address - Country:US
Mailing Address - Phone:707-540-9312
Mailing Address - Fax:707-540-9314
Practice Address - Street 1:901 GOLF COURSE DR
Practice Address - Street 2:
Practice Address - City:ROHNERT PARK
Practice Address - State:CA
Practice Address - Zip Code:94928-1800
Practice Address - Country:US
Practice Address - Phone:707-540-9312
Practice Address - Fax:707-540-9314
Is Sole Proprietor?:No
Enumeration Date:2015-08-31
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA71141183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist