Provider Demographics
NPI:1215187315
Name:AZEVEDO, FRANCISCO (PHARMD)
Entity Type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:
Last Name:AZEVEDO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:FRANK
Other - Middle Name:
Other - Last Name:AZEVEDO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1911 WILL SCARLET LN
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-4664
Mailing Address - Country:US
Mailing Address - Phone:209-598-9797
Mailing Address - Fax:
Practice Address - Street 1:1055 W COLLEGE AVE STE C
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401-5036
Practice Address - Country:US
Practice Address - Phone:707-575-1313
Practice Address - Fax:707-575-0104
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58464183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist