Provider Demographics
NPI:1609164854
Name:UYESUGI, BRIAN K (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:K
Last Name:UYESUGI
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 VINTAGE WAY
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94945-5007
Mailing Address - Country:US
Mailing Address - Phone:415-899-1337
Mailing Address - Fax:415-899-8544
Practice Address - Street 1:300 VINTAGE WAY
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-5007
Practice Address - Country:US
Practice Address - Phone:415-899-1337
Practice Address - Fax:415-899-8544
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA480261835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist