Provider Demographics
NPI:1811529993
Name:BACHAN, PIUS N JR (RPH)
Entity type:Individual
Prefix:
First Name:PIUS
Middle Name:N
Last Name:BACHAN
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 1:34573 HURST AVE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94555-3124
Mailing Address - Country:US
Mailing Address - Phone:510-290-6111
Mailing Address - Fax:
Practice Address - Street 1:34573 HURST AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94555-3124
Practice Address - Country:US
Practice Address - Phone:510-290-6111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA81493183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist