Provider Demographics
NPI:1679811335
Name:PASTRICK, MICHAEL (RPH)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:PASTRICK
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 1:2540 EAST ST
Mailing Address - Street 2:JOHN MUIR MEDICAL CENTER PHARMACY DEPARTMENT
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-1906
Mailing Address - Country:US
Mailing Address - Phone:925-674-2315
Mailing Address - Fax:
Practice Address - Street 1:2540 EAST ST
Practice Address - Street 2:JOHN MUIR MEDICAL CENTER PHARMACY DEPARTMENT
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-1906
Practice Address - Country:US
Practice Address - Phone:925-674-2315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-30
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28195183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist