Healthcare Provider Details

I. General information

NPI: 1740889922
Provider Name (Legal Business Name): ERNESTO DANIEL VIGIL PHARM.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2020
Last Update Date: 10/19/2021
Certification Date: 10/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

738 BANCROFT RD
WALNUT CREEK CA
94598-1593
US

IV. Provider business mailing address

738 BANCROFT RD
WALNUT CREEK CA
94598-1593
US

V. Phone/Fax

Practice location:
  • Phone: 925-938-8525
  • Fax: 925-938-0646
Mailing address:
  • Phone: 925-938-8525
  • Fax: 925-938-0646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number84025
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS024983
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: