Provider Demographics
NPI:1124502083
Name:BUYER, KYMBERLI SUZANNE (PHARMD)
Entity type:Individual
Prefix:
First Name:KYMBERLI
Middle Name:SUZANNE
Last Name:BUYER
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 1:4220 MILTON WAY
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94551-4823
Mailing Address - Country:US
Mailing Address - Phone:925-518-4739
Mailing Address - Fax:
Practice Address - Street 1:1449 E F ST
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:CA
Practice Address - Zip Code:95361-9265
Practice Address - Country:US
Practice Address - Phone:209-847-4279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-17
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA78886183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist