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NPI Code Detail

MEDICARE: DR. VITALY AVIGDOR RABINOVICCH RPH, PHARM. D.

MEDICARE: DR. VITALY AVIGDOR RABINOVICCH RPH, PHARM. D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist51598CA

General Provider Information

NPI Number : 1932512571
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VITALY AVIGDOR RABINOVICCH RPH, PHARM. D.
Provider Business Mailing Address
First Line : 3518 MARCONI AVE
Second Line :
City : SACRAMENTO
State : CA
Zip : 95821-5302
Country : US
Telephone Number : 916-972-7198
Fax Number :
Provider Business Practice Location Address
First Line : 3518 MARCONI AVE
Second Line :
City : SACRAMENTO
State : CA
Zip : 95821-5302
Country : US
Telephone Number : 916-972-7198
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2014
Last Update Date : 06/10/2014

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