Provider Demographics
NPI:1285907972
Name:OBERBECK, VACHAREE SUDHINARASET (PHARMD)
Entity type:Individual
Prefix:
First Name:VACHAREE
Middle Name:SUDHINARASET
Last Name:OBERBECK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:VACHAREE
Other - Middle Name:SUDHINARASET
Other - Last Name:OBERBECK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:380 LINARES AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-2210
Mailing Address - Country:US
Mailing Address - Phone:562-704-8206
Mailing Address - Fax:
Practice Address - Street 1:3841 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-3505
Practice Address - Country:US
Practice Address - Phone:562-427-7901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-12
Last Update Date:2012-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61592183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist