Healthcare Provider Details

I. General information

NPI: 1710070404
Provider Name (Legal Business Name): DINO REGINALD DE RANIERI BPHARM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 CRESTVIEW DRIVE
MILLBRAE CA
94030-1510
US

IV. Provider business mailing address

911 CRESTVIEW DRIVE
MILLBRAE CA
94030-1510
US

V. Phone/Fax

Practice location:
  • Phone: 650-589-9573
  • Fax:
Mailing address:
  • Phone: 650-589-9573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH 22939
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: