Provider Demographics
NPI:1124327119
Name:SCHWEITZ, RICHARD A (RPH)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:A
Last Name:SCHWEITZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12941 SYLVA LN
Mailing Address - Street 2:
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370-6995
Mailing Address - Country:US
Mailing Address - Phone:209-533-2809
Mailing Address - Fax:
Practice Address - Street 1:855 MONO WAY
Practice Address - Street 2:
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-5202
Practice Address - Country:US
Practice Address - Phone:209-588-0561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-16
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31616183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist