Provider Demographics
NPI:1003048521
Name:FILIPIOGLU-FAGO, ALIS (PHARM D, RPH)
Entity Type:Individual
Prefix:DR
First Name:ALIS
Middle Name:
Last Name:FILIPIOGLU-FAGO
Suffix:
Gender:F
Credentials:PHARM D, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 910213
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92191-0213
Mailing Address - Country:US
Mailing Address - Phone:619-794-6000
Mailing Address - Fax:858-536-9901
Practice Address - Street 1:7535 N PALM AVE STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-5504
Practice Address - Country:US
Practice Address - Phone:559-432-9800
Practice Address - Fax:559-432-2349
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-17
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41879183500000X
NV9791183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist