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STEVEN MITCHELL DIERKING
>> Pharmacist >> Pharmacy Service ProvidersRegistrant NPI Number: 1326601188
Individual Registrant: STEVEN MITCHELL DIERKING
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
1014 PACIFIC GROVE LN APT 2 PACIFIC GROVE, CA 93950-3857 US
Tel: 623-340-5235 Fax: --
Tel: 623-340-5235 Fax: --
Contact information for business:
1014 PACIFIC GROVE LN APT 2 PACIFIC GROVE, CA 93950-3857 US
Tel: -- Fax: --
Tel: -- Fax: --
Registration Information:
NPI: 1326601188
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 183500000X | Pharmacy Service Providers Pharmacist | CA | 79883 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
