Provider Demographics
NPI:1861976680
Name:NOMURA, DARRYL MINORU (PHARMD)
Entity type:Individual
Prefix:
First Name:DARRYL
Middle Name:MINORU
Last Name:NOMURA
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 1:1211 DURANT CT
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-6405
Mailing Address - Country:US
Mailing Address - Phone:925-360-5711
Mailing Address - Fax:
Practice Address - Street 1:1211 DURANT CT
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-6405
Practice Address - Country:US
Practice Address - Phone:925-360-5711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36976183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist