Provider Demographics
NPI:1609278852
Name:PINEDA, LARRY J (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:J
Last Name:PINEDA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
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Mailing Address - Street 1:1 UNIVERSITY OF NEW MEXICO
Mailing Address - Street 2:MSC09 5360
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87131-0001
Mailing Address - Country:US
Mailing Address - Phone:505-925-2414
Mailing Address - Fax:505-272-6749
Practice Address - Street 1:801 ENCINO PL NE
Practice Address - Street 2:BUILDING F
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-2612
Practice Address - Country:US
Practice Address - Phone:505-272-1312
Practice Address - Fax:505-272-2240
Is Sole Proprietor?:No
Enumeration Date:2014-09-18
Last Update Date:2015-03-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NMRP00007873183500000X
NMPC000002391835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist