Provider Demographics
NPI:1194993006
Name:DONG, DANIEL B (PHARM D)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:B
Last Name:DONG
Suffix:
Gender:M
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 1:1460 CATHERINE DR
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94702-1219
Mailing Address - Country:US
Mailing Address - Phone:510-816-0054
Mailing Address - Fax:
Practice Address - Street 1:1460 CATHERINE DR
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94702-1219
Practice Address - Country:US
Practice Address - Phone:510-816-0054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33295183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist