Provider Demographics
NPI:1154677888
Name:PARDO, ALLAN (PHARM D)
Entity Type:Individual
Prefix:
First Name:ALLAN
Middle Name:
Last Name:PARDO
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25454 MORNINGSTAR RD
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-2709
Mailing Address - Country:US
Mailing Address - Phone:626-523-4559
Mailing Address - Fax:
Practice Address - Street 1:618 MICHILLINDA AVE
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-6342
Practice Address - Country:US
Practice Address - Phone:626-821-7377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42370183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist