MEDICARE: DR. JAKE WILLIAM BACHINO PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	67723	CA

General Provider Information

NPI Number	:	1013260397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAKE WILLIAM BACHINO PHARM.D.

Provider Business Mailing Address
First Line	:	4380 WESTMINSTER LN
Second Line	:
City	:	ORCUTT
State	:	CA
Zip	:	93455-3665
Country	:	US
Telephone Number	:	805-878-8292
Fax Number	:

Provider Business Practice Location Address
First Line	:	223 E BETTERAVIA RD
Second Line	:
City	:	SANTA MARIA
State	:	CA
Zip	:	93454-7803
Country	:	US
Telephone Number	:	805-922-9904
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2012
Last Update Date	:	10/24/2012

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