Healthcare Provider Details

I. General information

NPI: 1992894901
Provider Name (Legal Business Name): JOEL ESTACIO CUARESMA PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4647 ZION AVE INPATIENT PHARMACY
SAN DIEGO CA
92120-2507
US

IV. Provider business mailing address

677 CAMINO DE ORCHIDIA
ENCINITAS CA
92024-3819
US

V. Phone/Fax

Practice location:
  • Phone: 619-528-3081
  • Fax:
Mailing address:
  • Phone: 619-528-3081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number49699
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: