Jonathan Fat
Pharmacist in Roseville, CA. Individual provider (NPI-1).
NPI number1730463589
StatusActive
Last updated in NPPESMar 31, 2017
Details
- NPI
- 1730463589
- Entity type
- Individual (NPI-1)
- Name
- Jonathan Fat
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 28, 2011
- Last updated
- Mar 31, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183500000X | Pharmacist | 65765 | CA | Yes |
Practice location
1001 Riverside AveRoseville, CA 95678-5134
Phone 916-746-4475
Mailing address
1001 Riverside AveRoseville, CA 95678-5134
Phone 916-746-4475
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