Provider Demographics
NPI:1679893838
Name:KOHN, HUGO ALFRED (RPH)
Entity type:Individual
Prefix:
First Name:HUGO
Middle Name:ALFRED
Last Name:KOHN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3149 DEERPARK DR
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3635
Mailing Address - Country:US
Mailing Address - Phone:925-945-0328
Mailing Address - Fax:
Practice Address - Street 1:1997 TICE VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94595-2201
Practice Address - Country:US
Practice Address - Phone:925-932-0568
Practice Address - Fax:925-932-0335
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-09
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39993183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist