1750663886 NPI number — DR. ROEL DAGUIO REYES PHARM.D.

Table of content: DR. ROEL DAGUIO REYES PHARM.D. (NPI 1750663886)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750663886 NPI number — DR. ROEL DAGUIO REYES PHARM.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
REYES
Provider First Name:
ROEL
Provider Middle Name:
DAGUIO
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARM.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750663886
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/14/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8895 DAFFODIL PLACE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GILROY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95020
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
831-776-1338
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1516 CONSTITUTION BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALINAS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93905-3803
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
831-444-3630
Provider Business Practice Location Address Fax Number:
831-444-3634
Provider Enumeration Date:
09/14/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  RPH 51768 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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