Provider Demographics
NPI:1013272061
Name:FABIAN, BONNIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:
Last Name:FABIAN
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 1:2238 GEARY BLVD FL 5
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3416
Mailing Address - Country:US
Mailing Address - Phone:415-833-0878
Mailing Address - Fax:415-833-3106
Practice Address - Street 1:2238 GEARY BLVD
Practice Address - Street 2:8TH FLOOR PHARMACY
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3416
Practice Address - Country:US
Practice Address - Phone:415-833-2865
Practice Address - Fax:415-833-8860
Is Sole Proprietor?:No
Enumeration Date:2012-07-05
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65556183500000X, 1835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology
No183500000XPharmacy Service ProvidersPharmacist