Healthcare Provider Details

I. General information

NPI: 1659860864
Provider Name (Legal Business Name): KRISTOPHER MICHAEL RIGAS PHARMD, TTS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2018
Last Update Date: 09/03/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1104 S MAIN AVE
FALLBROOK CA
92028-3325
US

IV. Provider business mailing address

1104 S MAIN AVE
FALLBROOK CA
92028-3325
US

V. Phone/Fax

Practice location:
  • Phone: 760-645-3880
  • Fax:
Mailing address:
  • Phone: 760-645-3880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number74371
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: