Provider Demographics
NPI:1467994368
Name:CERVANTES, CHRISTOPHER DANIEL ALVARADO (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:DANIEL ALVARADO
Last Name:CERVANTES
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 1:13803 FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-3013
Mailing Address - Country:US
Mailing Address - Phone:818-362-2816
Mailing Address - Fax:
Practice Address - Street 1:13803 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-3013
Practice Address - Country:US
Practice Address - Phone:818-362-2816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-08
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA75551183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist