Provider Demographics
NPI:1518057058
Name:SANTOS, ROGER ALMANZA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:ALMANZA
Last Name:SANTOS
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 1:440 SCENIC AVE
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94611-3421
Mailing Address - Country:US
Mailing Address - Phone:510-220-6531
Mailing Address - Fax:
Practice Address - Street 1:3801 HOWE STREET
Practice Address - Street 2:FABIOLA BUILDING, G84
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611
Practice Address - Country:US
Practice Address - Phone:510-752-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55085183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist