Provider Demographics
NPI:1093466450
Name:IGARASHI, DAVID ISAMI (PHARMD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ISAMI
Last Name:IGARASHI
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 1:1183 E FOOTHILL BLVD STE 130
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-4084
Mailing Address - Country:US
Mailing Address - Phone:909-608-1832
Mailing Address - Fax:909-608-1871
Practice Address - Street 1:1183 E FOOTHILL BLVD STE 130
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4084
Practice Address - Country:US
Practice Address - Phone:909-608-1832
Practice Address - Fax:909-608-1871
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-17
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH35481183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist