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General NPI Number Information
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NPI Number | 1770368540
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Entity Type | Individual
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Provider Name | JOHN ERGINO PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/29/2023
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Last Update Date | 08/29/2023
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Provider Practice Location Address
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Address Line | 15650 SAN PABLO AVE
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City | SAN PABLO
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State | CA
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Zip | 94806-1240
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Country | US
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Telephone | 510-243-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 4949 CHURCH ST
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City | SKOKIE
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State | IL
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Zip | 60077-1294
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Country | US
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Telephone |
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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 | 88021
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License Number State | CA
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