Provider Demographics
NPI:1225635048
Name:ESTAPHNOUS, DAVID SAMIR (PHARMD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:SAMIR
Last Name:ESTAPHNOUS
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 1:28439 WARE ST
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-4409
Mailing Address - Country:US
Mailing Address - Phone:714-423-8850
Mailing Address - Fax:
Practice Address - Street 1:30736 BENTON RD
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:CA
Practice Address - Zip Code:92596-8466
Practice Address - Country:US
Practice Address - Phone:951-926-1223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83466183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist