Provider Demographics
NPI:1003123472
Name:VAKILI, FRANK (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:
Last Name:VAKILI
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27732 BAHAMONDE
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-3234
Mailing Address - Country:US
Mailing Address - Phone:949-367-0507
Mailing Address - Fax:
Practice Address - Street 1:24330 EL TORO ROAD
Practice Address - Street 2:
Practice Address - City:LAGUNA WOODS
Practice Address - State:CA
Practice Address - Zip Code:92637
Practice Address - Country:US
Practice Address - Phone:949-830-0391
Practice Address - Fax:949-830-1141
Is Sole Proprietor?:No
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 43785183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist