Provider Demographics
NPI:1659567923
Name:SAXTON, CURTIS
Entity Type:Individual
Prefix:MR
First Name:CURTIS
Middle Name:
Last Name:SAXTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5665 N PERSHING AVE
Mailing Address - Street 2:STE A6
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-4948
Mailing Address - Country:US
Mailing Address - Phone:209-477-3032
Mailing Address - Fax:209-411-3049
Practice Address - Street 1:5665 N PERSHING AVE
Practice Address - Street 2:STE A6
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-4948
Practice Address - Country:US
Practice Address - Phone:209-477-3032
Practice Address - Fax:209-411-3049
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY45427183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0563002OtherPHY45427