MEDICARE: MR. ERNESTO CARIAGA JR. RPH

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	64315	CA

General Provider Information

NPI Number	:	1417365552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ERNESTO CARIAGA JR. RPH

Provider Business Mailing Address
First Line	:	4423 STRIPED MAPLE CT
Second Line	:
City	:	CONCORD
State	:	CA
Zip	:	94521-4328
Country	:	US
Telephone Number	:	925-323-3180
Fax Number	:

Provider Business Practice Location Address
First Line	:	4423 STRIPED MAPLE CT
Second Line	:
City	:	CONCORD
State	:	CA
Zip	:	94521-4328
Country	:	US
Telephone Number	:	925-323-3180
Fax Number	:

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

Provider Enumeration Date	:	07/31/2014
Last Update Date	:	07/31/2014

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