Provider Demographics
NPI:1255684510
Name:ENGELMANN, ALEXANDER JOACHIM (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:JOACHIM
Last Name:ENGELMANN
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 1:813 E ST
Mailing Address - Street 2:APT 6
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95814-1321
Mailing Address - Country:US
Mailing Address - Phone:678-622-7224
Mailing Address - Fax:
Practice Address - Street 1:4195 NORWOOD AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95838-2623
Practice Address - Country:US
Practice Address - Phone:916-418-0322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-23
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA68095183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist