Provider Demographics
NPI:1902350333
Name:PARDINI, MARK VICTOR (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:VICTOR
Last Name:PARDINI
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9890 GAINSBOROUGH LN
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-4381
Mailing Address - Country:US
Mailing Address - Phone:209-765-3270
Mailing Address - Fax:
Practice Address - Street 1:9890 GAINSBOROUGH LN
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-4381
Practice Address - Country:US
Practice Address - Phone:209-765-3270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-15
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV08849183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1902350333Medicaid