Provider Demographics
NPI:1033495908
Name:GOLDSTEIN, SARA ELAINE (RPH)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:ELAINE
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 GREGORY LN
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-2763
Mailing Address - Country:US
Mailing Address - Phone:925-944-1592
Mailing Address - Fax:925-944-5976
Practice Address - Street 1:721 GREGORY LN
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-2763
Practice Address - Country:US
Practice Address - Phone:925-944-1592
Practice Address - Fax:925-944-5976
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-24
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42695183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist