Healthcare Provider Details

I. General information

NPI: 1710549167
Provider Name (Legal Business Name): CESAR A. BEJARANO-GARCIA PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2019
Last Update Date: 07/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1340 SMITH AVE STE A
BALTIMORE MD
21209-3736
US

IV. Provider business mailing address

3250 CENTENNIAL WAY APT 312
FREDERICK MD
21704-7444
US

V. Phone/Fax

Practice location:
  • Phone: 443-388-8710
  • Fax:
Mailing address:
  • Phone: 202-997-9676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26142
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: