Provider Demographics
NPI:1619331915
Name:HITCHMAN, CRAIG (RPH)
Entity Type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:
Last Name:HITCHMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 PEONY
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-1508
Mailing Address - Country:US
Mailing Address - Phone:949-293-8839
Mailing Address - Fax:
Practice Address - Street 1:1150 E YORBA LINDA BLVD
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-3828
Practice Address - Country:US
Practice Address - Phone:714-982-1708
Practice Address - Fax:714-982-1709
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-12
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH43820183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist