Provider Demographics
NPI:1730796434
Name:PAO, WILLIAM (PHARMD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:PAO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 E REED ST UNIT 713
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-5990
Mailing Address - Country:US
Mailing Address - Phone:516-732-8846
Mailing Address - Fax:
Practice Address - Street 1:1750 STORY RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95122-1921
Practice Address - Country:US
Practice Address - Phone:408-273-0055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-26
Last Update Date:2020-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA81672183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist