Provider Demographics
NPI:1366763328
Name:LABARCON, HANK AARON RAGANIT (RPH)
Entity type:Individual
Prefix:
First Name:HANK AARON
Middle Name:RAGANIT
Last Name:LABARCON
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 1:119 NOVA ALBION WAY
Mailing Address - Street 2:329
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-3508
Mailing Address - Country:US
Mailing Address - Phone:415-717-5566
Mailing Address - Fax:
Practice Address - Street 1:1500 NORTHGATE MALL
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-3671
Practice Address - Country:US
Practice Address - Phone:415-492-0888
Practice Address - Fax:415-492-0551
Is Sole Proprietor?:No
Enumeration Date:2010-06-14
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61003183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist