Provider Demographics
NPI:1386934685
Name:SARGISIAN, ROBERT (PHARMACIST)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:SARGISIAN
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3371 COLORADO AVE
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-8126
Mailing Address - Country:US
Mailing Address - Phone:209-669-5731
Mailing Address - Fax:209-632-9008
Practice Address - Street 1:651 N GOLDEN STATE BLVD
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380-3952
Practice Address - Country:US
Practice Address - Phone:209-634-5831
Practice Address - Fax:209-632-9008
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-08
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51428183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist