Provider Demographics
NPI:1851420210
Name:VALMIDIANO, GIL RODRIGUEZ (PHARMD)
Entity Type:Individual
Prefix:
First Name:GIL
Middle Name:RODRIGUEZ
Last Name:VALMIDIANO
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 1:1509 WELCH PL
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-7043
Mailing Address - Country:US
Mailing Address - Phone:619-656-6944
Mailing Address - Fax:619-656-3869
Practice Address - Street 1:2230 OTAY LAKES RD
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91915-1000
Practice Address - Country:US
Practice Address - Phone:619-656-6944
Practice Address - Fax:619-656-3869
Is Sole Proprietor?:No
Enumeration Date:2007-03-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH49541183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist