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General NPI Number Information
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NPI Number | 1497631303
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Entity Type | Individual
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Provider Name | SAMUEL PETER RYDELL PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/14/2025
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 5020 ELLINGHOUSE DR STE E
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City | COOL
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State | CA
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Zip | 95614-9569
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Country | US
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Telephone | 530-889-1427
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Fax |
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Provider Business Mailing Address
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Address Line | 5020 ELLINGHOUSE DR STE E
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City | COOL
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State | CA
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Zip | 95614-9569
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Country | US
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Telephone | 530-889-1427
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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 | 82604
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License Number State | CA
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