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General NPI Number Information
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NPI Number | 1578709820
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Entity Type | Individual
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Provider Name | RYAN DAVID RACINO PHARM.D., AAHIVP
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Gender | Male
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Dates
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Enumeration Date | 12/16/2008
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Last Update Date | 05/14/2014
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Provider Practice Location Address
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Address Line | 4145 IOWA ST APARTMENT 1
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City | SAN DIEGO
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State | CA
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Zip | 92104-6906
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Country | US
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Telephone | 619-577-3795
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Fax |
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Provider Business Mailing Address
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Address Line | 4145 IOWA ST APARTMENT 1
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City | SAN DIEGO
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State | CA
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Zip | 92104-6906
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Country | US
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Telephone | 215-870-6512
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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 | RP441871
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 63651
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License Number State | CA
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