Provider Demographics
NPI:1457650541
Name:CAMOIRANO, SCOTT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:CAMOIRANO
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 1:900 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95336-3743
Mailing Address - Country:US
Mailing Address - Phone:209-239-4175
Mailing Address - Fax:209-239-0980
Practice Address - Street 1:900 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95336-3743
Practice Address - Country:US
Practice Address - Phone:209-239-4175
Practice Address - Fax:209-239-0980
Is Sole Proprietor?:No
Enumeration Date:2011-03-15
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48903183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist