Provider Demographics
NPI:1376979377
Name:ARSLANIAN, JACOB V (RPH)
Entity Type:Individual
Prefix:DR
First Name:JACOB
Middle Name:V
Last Name:ARSLANIAN
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 1:3026 E SAINT ANDREWS DR
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91761-7553
Mailing Address - Country:US
Mailing Address - Phone:916-919-7542
Mailing Address - Fax:
Practice Address - Street 1:15318 ROY ROGERS DR
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92394-2160
Practice Address - Country:US
Practice Address - Phone:760-952-7555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-23
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69201183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist