Provider Demographics
NPI:1710549167
Name:BEJARANO-GARCIA, CESAR A (PHARMD)
Entity Type:Individual
Prefix:
First Name:CESAR
Middle Name:A
Last Name:BEJARANO-GARCIA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3250 CENTENNIAL WAY APT 312
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21704-7444
Mailing Address - Country:US
Mailing Address - Phone:202-997-9676
Mailing Address - Fax:
Practice Address - Street 1:1340 SMITH AVE STE A
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-3736
Practice Address - Country:US
Practice Address - Phone:443-388-8710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-06
Last Update Date:2019-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26142183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD26142OtherBOARD OF PHARMACY