Provider Demographics
NPI:1962701060
Name:CAMOIRANO, JAMES RONALD (RPH)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:RONALD
Last Name:CAMOIRANO
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 1:1830 MITCHELL RD
Mailing Address - Street 2:
Mailing Address - City:CERES
Mailing Address - State:CA
Mailing Address - Zip Code:95307-2163
Mailing Address - Country:US
Mailing Address - Phone:209-538-4927
Mailing Address - Fax:209-538-6991
Practice Address - Street 1:1830 MITCHELL RD
Practice Address - Street 2:
Practice Address - City:CERES
Practice Address - State:CA
Practice Address - Zip Code:95307-2163
Practice Address - Country:US
Practice Address - Phone:209-538-4927
Practice Address - Fax:209-538-6991
Is Sole Proprietor?:No
Enumeration Date:2011-03-15
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26358183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist