Provider Demographics
NPI:1164958781
Name:OLMEDO, CESAR A (PHARMD)
Entity Type:Individual
Prefix:
First Name:CESAR
Middle Name:A
Last Name:OLMEDO
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 1:8800 SIERRA COLLEGE BLVD
Mailing Address - Street 2:APT 633
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-6414
Mailing Address - Country:US
Mailing Address - Phone:949-282-9834
Mailing Address - Fax:916-666-7814
Practice Address - Street 1:8800 SIERRA COLLEGE BLVD
Practice Address - Street 2:APT 633
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-6414
Practice Address - Country:US
Practice Address - Phone:949-282-9834
Practice Address - Fax:916-666-7814
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-02
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55034183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist