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General NPI Number Information
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NPI Number | 1255883658
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Entity Type | Individual
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Provider Name | DEO CLARBEN BIGORNIA MOPERA PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 11/01/2016
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Last Update Date | 11/01/2016
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Provider Practice Location Address
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Address Line | 6200 N LA CHOLLA BLVD
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City | TUCSON
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State | AZ
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Zip | 85741-3529
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Country | US
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Telephone | 520-742-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 4657 E AVENIDA LOS VALLECITOS
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City | TUCSON
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State | AZ
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Zip | 85712-6032
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Country | US
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Telephone | 480-246-7670
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | S022173
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License Number State | AZ
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