Provider Demographics
NPI:1417557620
Name:RASGO, FELIX (PHARMD)
Entity Type:Individual
Prefix:
First Name:FELIX
Middle Name:
Last Name:RASGO
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 1:150 N BURL AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-6825
Mailing Address - Country:US
Mailing Address - Phone:559-412-9857
Mailing Address - Fax:
Practice Address - Street 1:1400 HOWARD RD
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93637-5125
Practice Address - Country:US
Practice Address - Phone:559-661-8380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83394183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist