Provider Demographics
NPI:1093280596
Name:LUGOLOLE, RONALD (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:
Last Name:LUGOLOLE
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 MACDONALD AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94805-2307
Mailing Address - Country:US
Mailing Address - Phone:510-253-1001
Mailing Address - Fax:510-253-1011
Practice Address - Street 1:1435 E GRAND AVE
Practice Address - Street 2:
Practice Address - City:ARROYO GRANDE
Practice Address - State:CA
Practice Address - Zip Code:93420-2423
Practice Address - Country:US
Practice Address - Phone:805-474-5720
Practice Address - Fax:805-474-5725
Is Sole Proprietor?:No
Enumeration Date:2018-10-10
Last Update Date:2019-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA773191835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist