DR. MIRA SURJANTO, PHARM.D.

Pharmacist

Active Individual
NPI: 1124110705

Practice Address

975 SERENO DR
MOB MEDICINE 7
Vallejo, CA 94589

Phone: (707) 651-2584

Specialties

Specialty Code Primary License
Pharmacist 183500000X Yes 51280 (CA)

Frequently Asked Questions

NPI 1124110705 is the National Provider Identifier for DR. MIRA SURJANTO, PHARM.D., a Pharmacist provider located in Vallejo, CA. This NPI was enumerated on September 29, 2006.
DR. MIRA SURJANTO, PHARM.D. practices at 975 SERENO DR, MOB MEDICINE 7, Vallejo, CA 94589.

Quick Facts

NPI
1124110705
Type
Individual
Enumerated
Sep 29, 2006
Last Updated
Jul 8, 2007

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