Provider Demographics
NPI:1346521382
Name:PINGORIO, MARIA DOLORES AGUIRRE (RPH)
Entity Type:Individual
Prefix:
First Name:MARIA DOLORES
Middle Name:AGUIRRE
Last Name:PINGORIO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 TIDEWAY DR
Mailing Address - Street 2:#314
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-3571
Mailing Address - Country:US
Mailing Address - Phone:510-219-2306
Mailing Address - Fax:510-523-7043
Practice Address - Street 1:2300 OTIS DR
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-5722
Practice Address - Country:US
Practice Address - Phone:510-523-7043
Practice Address - Fax:510-523-7021
Is Sole Proprietor?:No
Enumeration Date:2011-09-05
Last Update Date:2011-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63923183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist