Provider Demographics
NPI:1326342619
Name:SESE, ROLEN CALEON (RPH)
Entity Type:Individual
Prefix:
First Name:ROLEN
Middle Name:CALEON
Last Name:SESE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1999 MOWRY AVE
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1738
Mailing Address - Country:US
Mailing Address - Phone:510-793-5011
Mailing Address - Fax:510-792-9599
Practice Address - Street 1:1999 MOWRY AVE
Practice Address - Street 2:SUITE 2A
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1738
Practice Address - Country:US
Practice Address - Phone:510-793-5011
Practice Address - Fax:510-792-9599
Is Sole Proprietor?:No
Enumeration Date:2011-01-01
Last Update Date:2011-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 63782183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist