Provider Demographics
NPI:1710124904
Name:APOSTOL, NOMINADO SIAZON JR (RPH)
Entity Type:Individual
Prefix:
First Name:NOMINADO
Middle Name:SIAZON
Last Name:APOSTOL
Suffix:JR
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 1:7140 INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-4544
Mailing Address - Country:US
Mailing Address - Phone:951-358-6115
Mailing Address - Fax:951-358-6107
Practice Address - Street 1:7140 INDIANA AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-4544
Practice Address - Country:US
Practice Address - Phone:951-358-6115
Practice Address - Fax:951-358-6107
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43461183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist