Provider Demographics
NPI:1720806953
Name:SASSOLA, MARCEL III (RPH)
Entity type:Individual
Prefix:MR
First Name:MARCEL
Middle Name:
Last Name:SASSOLA
Suffix:III
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 1:5018 READ RD
Mailing Address - Street 2:
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93021-8765
Mailing Address - Country:US
Mailing Address - Phone:818-388-9080
Mailing Address - Fax:866-496-5915
Practice Address - Street 1:2946 DE LA VINA ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-3310
Practice Address - Country:US
Practice Address - Phone:805-967-9990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-27
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH40870183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist