Provider Demographics
NPI:1891073490
Name:MCALPIN, CLYDE M (RPH)
Entity Type:Individual
Prefix:
First Name:CLYDE
Middle Name:M
Last Name:MCALPIN
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 1:1900 SANTA ROSA AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95407-7621
Mailing Address - Country:US
Mailing Address - Phone:707-578-1711
Mailing Address - Fax:707-578-6287
Practice Address - Street 1:1900 SANTA ROSA AVE
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95407-7621
Practice Address - Country:US
Practice Address - Phone:707-578-1711
Practice Address - Fax:707-578-6287
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-30
Last Update Date:2011-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46014183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist