Provider Demographics
NPI:1073960662
Name:LUND, STEPHEN ERIK (PHARMD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:ERIK
Last Name:LUND
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 1:1051 N ARMSTRONG AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-9596
Mailing Address - Country:US
Mailing Address - Phone:707-484-0837
Mailing Address - Fax:401-216-0056
Practice Address - Street 1:7094 N WEST AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-0462
Practice Address - Country:US
Practice Address - Phone:559-341-6664
Practice Address - Fax:401-216-0056
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-24
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59884183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist