Provider Demographics
NPI:1144621434
Name:SIRICH, ERIC (PHARMD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:SIRICH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 W ROUTE 66
Mailing Address - Street 2:SUITE 103
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-4174
Mailing Address - Country:US
Mailing Address - Phone:626-335-0011
Mailing Address - Fax:626-335-1499
Practice Address - Street 1:707 W ROUTE 66
Practice Address - Street 2:SUITE 103
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-4174
Practice Address - Country:US
Practice Address - Phone:626-335-0011
Practice Address - Fax:626-335-1499
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-06
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55877183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist