MEDICARE: ANTHONY RENE ARIZPE PHARMD

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	70820	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	70820	OTHER	TX	TEXAS PHARMACIST LICENSE

General Provider Information

NPI Number	:	1629705850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY RENE ARIZPE PHARMD

Provider Business Mailing Address
First Line	:	835 ARIZPE RD
Second Line	:
City	:	CIBOLO
State	:	TX
Zip	:	78108-4012
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11201 BENTON ST
Second Line	:
City	:	LOMA LINDA
State	:	CA
Zip	:	92357-4118
Country	:	US
Telephone Number	:	909-825-7084
Fax Number	:

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

Provider Enumeration Date	:	08/08/2022
Last Update Date	:	03/11/2026

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