Provider Demographics
NPI:1952647489
Name:TADROS, MICHAEL EDWARD MILAD (RPH)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:EDWARD MILAD
Last Name:TADROS
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 1:2494 DAKIN DR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-6193
Mailing Address - Country:US
Mailing Address - Phone:626-234-3186
Mailing Address - Fax:
Practice Address - Street 1:10237 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3440
Practice Address - Country:US
Practice Address - Phone:951-509-9277
Practice Address - Fax:951-509-9288
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-03
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy