Provider Demographics
NPI:1437590361
Name:SCORSATTO, ALLEN FRANK (RPH)
Entity Type:Individual
Prefix:MR
First Name:ALLEN
Middle Name:FRANK
Last Name:SCORSATTO
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 1:24747 REDLANDS BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-4023
Mailing Address - Country:US
Mailing Address - Phone:909-796-2140
Mailing Address - Fax:909-796-7942
Practice Address - Street 1:24747 REDLANDS BLVD STE D
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-4023
Practice Address - Country:US
Practice Address - Phone:909-796-2140
Practice Address - Fax:909-796-7942
Is Sole Proprietor?:No
Enumeration Date:2013-07-08
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH26918183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist