Provider Demographics
NPI:1891133492
Name:MCDONALD, DONALD EDWARD (PHARM)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:EDWARD
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:PHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 HANOVER RD
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-2611
Mailing Address - Country:US
Mailing Address - Phone:909-621-2633
Mailing Address - Fax:909-624-3073
Practice Address - Street 1:1835 HANOVER RD
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-2611
Practice Address - Country:US
Practice Address - Phone:909-621-2633
Practice Address - Fax:909-624-3073
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-05
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA221071835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA22107OtherPHARMACY LICENSE NUMBER