Provider Demographics
NPI:1104299411
Name:CHIAGHANA, ALEXANDER C JR (PHARMD)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:C
Last Name:CHIAGHANA
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 48615
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-0615
Mailing Address - Country:US
Mailing Address - Phone:626-214-5399
Mailing Address - Fax:
Practice Address - Street 1:8550 S PRIEST DR
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-1902
Practice Address - Country:US
Practice Address - Phone:626-214-5399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-09
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ017309183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist