Provider Demographics
NPI:1255500989
Name:CEBALLOS, RONALD GEORGE (PHARMD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:GEORGE
Last Name:CEBALLOS
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 1:7060 CLAIREMONT MESA BLVD
Mailing Address - Street 2:1ST FLOOR OUTPATIENT PHARMACY
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-1003
Mailing Address - Country:US
Mailing Address - Phone:858-573-5307
Mailing Address - Fax:858-573-5592
Practice Address - Street 1:7060 CLAIREMONT MESA BLVD
Practice Address - Street 2:1ST FLOOR OUTPATIENT PHARMACY
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-1003
Practice Address - Country:US
Practice Address - Phone:858-573-5307
Practice Address - Fax:858-573-5592
Is Sole Proprietor?:No
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH44047183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist