Provider Demographics
NPI:1609957422
Name:NAMIMATSU, TRACY KIMIYO FUJIWARA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TRACY
Middle Name:KIMIYO FUJIWARA
Last Name:NAMIMATSU
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 1:13755 CALLE TACUBA
Mailing Address - Street 2:
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-4920
Mailing Address - Country:US
Mailing Address - Phone:408-867-8656
Mailing Address - Fax:408-867-3430
Practice Address - Street 1:555 CASTRO ST
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94041-2009
Practice Address - Country:US
Practice Address - Phone:650-903-2779
Practice Address - Fax:650-903-2128
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47707183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist