Provider Demographics
NPI:1831823624
Name:CAVALARI, ALEX JORDAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ALEX
Middle Name:JORDAN
Last Name:CAVALARI
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 1:4404 DEL RIO RD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95822-1126
Mailing Address - Country:US
Mailing Address - Phone:916-452-2200
Mailing Address - Fax:
Practice Address - Street 1:4404 DEL RIO RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95822-1126
Practice Address - Country:US
Practice Address - Phone:916-452-2200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-15
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH71219183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist