Provider Demographics
NPI:1114401163
Name:RAMIREZ, REGINALD MAGTIRA (PHARMD)
Entity type:Individual
Prefix:
First Name:REGINALD
Middle Name:MAGTIRA
Last Name:RAMIREZ
Suffix:
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 1:5180 E KINGS CANYON RD
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-3971
Mailing Address - Country:US
Mailing Address - Phone:559-255-9009
Mailing Address - Fax:559-255-9191
Practice Address - Street 1:5180 E KINGS CANYON RD
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-3971
Practice Address - Country:US
Practice Address - Phone:559-255-9009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-15
Last Update Date:2018-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA78425183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty