Provider Demographics
NPI:1487023396
Name:RICCI, ANTHONY L (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:L
Last Name:RICCI
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10919 SPICEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-4825
Mailing Address - Country:US
Mailing Address - Phone:858-755-5707
Mailing Address - Fax:858-481-4949
Practice Address - Street 1:12750 CARMEL COUNTRY RD
Practice Address - Street 2:SUITE A101
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-2159
Practice Address - Country:US
Practice Address - Phone:858-481-4990
Practice Address - Fax:858-481-4949
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-21
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43096183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist