Provider Demographics
NPI:1326372608
Name:DUENAS, RICARDO ANGEL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:ANGEL
Last Name:DUENAS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 REDWOOD ST
Mailing Address - Street 2:SUITE#33
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-2958
Mailing Address - Country:US
Mailing Address - Phone:707-200-4411
Mailing Address - Fax:707-652-5906
Practice Address - Street 1:3495 SONOMA BLVD STE K
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-2984
Practice Address - Country:US
Practice Address - Phone:707-200-4411
Practice Address - Fax:707-652-5906
Is Sole Proprietor?:No
Enumeration Date:2009-09-19
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63058183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist