Provider Demographics
NPI:1497075030
Name:MOK, ELIZABETH T (PHARM D)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:T
Last Name:MOK
Suffix:
Gender:F
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 1:1120 LARCH AVE
Mailing Address - Street 2:
Mailing Address - City:MORAGA
Mailing Address - State:CA
Mailing Address - Zip Code:94556-2602
Mailing Address - Country:US
Mailing Address - Phone:925-376-8790
Mailing Address - Fax:
Practice Address - Street 1:3353 DEER VALLEY RD
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-6664
Practice Address - Country:US
Practice Address - Phone:925-757-3390
Practice Address - Fax:925-757-0244
Is Sole Proprietor?:No
Enumeration Date:2010-06-06
Last Update Date:2010-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29515183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist