Healthcare Provider Details

I. General information

NPI: 1366722563
Provider Name (Legal Business Name): CLINT RAYMOND HUTCHINGS PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2011
Last Update Date: 08/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 S ARROYO PKWY #324
PASADENA CA
91105-5209
US

IV. Provider business mailing address

275 S. ARROYO PARKWAY #324
PASADENA CA
91105-5212
US

V. Phone/Fax

Practice location:
  • Phone: 626-394-2532
  • Fax:
Mailing address:
  • Phone: 626-394-2532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number61340
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: