Provider Demographics
NPI:1861738809
Name:ESPIRITU, ALAN GREGORY (PHARMD)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:GREGORY
Last Name:ESPIRITU
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 1:1480 MIRA VALLE ST
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-5322
Mailing Address - Country:US
Mailing Address - Phone:626-429-9180
Mailing Address - Fax:
Practice Address - Street 1:4940 VAN NUYS BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-1700
Practice Address - Country:US
Practice Address - Phone:866-209-7367
Practice Address - Fax:818-351-3087
Is Sole Proprietor?:No
Enumeration Date:2012-12-19
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48704183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist