Provider Demographics
NPI:1457498073
Name:TOY, KEVIN L (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:L
Last Name:TOY
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7836
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95267-0836
Mailing Address - Country:US
Mailing Address - Phone:209-870-2760
Mailing Address - Fax:209-870-2769
Practice Address - Street 1:89 W MARCH LN
Practice Address - Street 2:STE. 2
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-5721
Practice Address - Country:US
Practice Address - Phone:209-870-2760
Practice Address - Fax:209-870-2769
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36972183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA464010Medicaid