Provider Demographics
NPI:1124470521
Name:ESTRADA, ARNOLD (PHARMD)
Entity type:Individual
Prefix:MR
First Name:ARNOLD
Middle Name:
Last Name:ESTRADA
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 1:777 LAKEVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112-2203
Mailing Address - Country:US
Mailing Address - Phone:415-519-0667
Mailing Address - Fax:
Practice Address - Street 1:777 LAKEVIEW AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94112-2203
Practice Address - Country:US
Practice Address - Phone:415-519-0667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-08
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46246183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist