Provider Demographics
NPI:1790061364
Name:GAE, DARREN DONG-SHUNG (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DARREN
Middle Name:DONG-SHUNG
Last Name:GAE
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 1:11440 WINDEMERE PKWY
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94582
Mailing Address - Country:US
Mailing Address - Phone:925-364-6401
Mailing Address - Fax:925-364-6402
Practice Address - Street 1:11440 WINDEMERE PKWY
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94582
Practice Address - Country:US
Practice Address - Phone:925-364-6401
Practice Address - Fax:925-364-6402
Is Sole Proprietor?:No
Enumeration Date:2011-10-27
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH232701183500000X
CARPH63423183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist