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General NPI Number Information
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NPI Number | 1316389976
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Entity Type | Individual
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Provider Name | FRANK G LAIACONA PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/24/2013
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Last Update Date | 07/24/2013
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Provider Practice Location Address
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Address Line | 914 PINE ST
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City | MOUNT SHASTA
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State | CA
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Zip | 96067-2143
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Country | US
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Telephone | 530-859-2814
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Fax | 530-926-9306
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Provider Business Mailing Address
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Address Line | PO BOX 1512
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City | MOUNT SHASTA
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State | CA
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Zip | 96067-1512
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Country | US
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Telephone | 530-859-2814
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Fax | 530-926-9306
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 17610
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 35608
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 1953
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License Number State | HI
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