Healthcare Provider Details

I. General information

NPI: 1033262456
Provider Name (Legal Business Name): MICHAEL V CIPRIANO RPH., BCPS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 12/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34800 BOB WILSON DR PHARMACY DEPARTMENT
SAN DIEGO CA
92134-1098
US

IV. Provider business mailing address

444 E 6TH AVE
ESCONDIDO CA
92025-4319
US

V. Phone/Fax

Practice location:
  • Phone: 619-532-8595
  • Fax:
Mailing address:
  • Phone: 858-623-9875
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number42859
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number14993
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: