Provider Demographics
NPI:1902904519
Name:TOMASCO, MARY BETH (PHARMD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:BETH
Last Name:TOMASCO
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 1:18 ELGIN PARK
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-1106
Mailing Address - Country:US
Mailing Address - Phone:415-863-4544
Mailing Address - Fax:415-431-4413
Practice Address - Street 1:4150 CLEMENT ST
Practice Address - Street 2:PHARMACY-119
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-1545
Practice Address - Country:US
Practice Address - Phone:415-221-4810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA043439183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist