Healthcare Provider Details

I. General information

NPI: 1003048521
Provider Name (Legal Business Name): ALIS FILIPIOGLU-FAGO PHARM. D., RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2009
Last Update Date: 08/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7535 N PALM AVE STE 101
FRESNO CA
93711-5504
US

IV. Provider business mailing address

PO BOX 910213
SAN DIEGO CA
92191-0213
US

V. Phone/Fax

Practice location:
  • Phone: 559-432-9800
  • Fax: 559-432-2349
Mailing address:
  • Phone: 619-794-6000
  • Fax: 858-536-9901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number41879
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number9791
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: