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Ccwf — NPI 1790031995, Lafayette, CA | NPI Central

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NPI 1790031995

OrganizationActive

Ccwf

NPI 1790031995 · PACE Provider Organization · Lafayette, CA

Provider details

NPI number: 1790031995
Entity type: Organization
Primary specialty: PACE Provider OrganizationAgencies
Organization subpart: No
Authorized official: Donald De Zordo, Pharm D(559) 665-5531
License: RPH23059 (CA)

Specialties & taxonomies

PACE Provider OrganizationPrimary251T00000XLicense RPH23059 (CA)
Agencies

Practice location

3688 Boyer Cir

Lafayette, CA 94549-4904

Phone: (510) 910-7244

Approximate (ZIP-level) locationGet directions

More CA providers

Mailing address

3688 Boyer Cir

Lafayette, CA 94549-4904

Registry dates

Enumerated: 2012-07-25
Last updated: 2012-07-25

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.