Provider Demographics
NPI:1417365552
Name:CARIAGA, ERNESTO JR (RPH)
Entity type:Individual
Prefix:MR
First Name:ERNESTO
Middle Name:
Last Name:CARIAGA
Suffix:JR
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 1:4423 STRIPED MAPLE CT
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94521-4328
Mailing Address - Country:US
Mailing Address - Phone:925-323-3180
Mailing Address - Fax:
Practice Address - Street 1:4423 STRIPED MAPLE CT
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94521-4328
Practice Address - Country:US
Practice Address - Phone:925-323-3180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64315183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist