Provider Demographics
NPI:1659612877
Name:ESTRIN, ELBION
Entity Type:Individual
Prefix:
First Name:ELBION
Middle Name:
Last Name:ESTRIN
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 1:9105 BAY MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-6859
Mailing Address - Country:US
Mailing Address - Phone:310-600-7412
Mailing Address - Fax:
Practice Address - Street 1:9105 BAY MEADOWS DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89523-6859
Practice Address - Country:US
Practice Address - Phone:310-600-7412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-13
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV03573183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist