Healthcare Provider Details

I. General information

NPI: 1982928396
Provider Name (Legal Business Name): CALIFORNIA DRUG CONSULTANTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2010
Last Update Date: 03/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14265 NASON ST
MORENO VALLEY CA
92555-4725
US

IV. Provider business mailing address

11751 DAVIS ST
MORENO VALLEY CA
92557-6316
US

V. Phone/Fax

Practice location:
  • Phone: 951-247-6115
  • Fax: 951-247-5611
Mailing address:
  • Phone: 951-243-3837
  • Fax: 951-485-2642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number336405884
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number336405884
License Number StateCA

VIII. Authorized Official

Name: DR. CARL E. ROWE
Title or Position: EXECUTIVE DIRECTOR
Credential: PHARM. D.
Phone: 951-243-3837