Provider Demographics
NPI:1992844666
Name:RESCOBER, FELIPE ROVILLOS JR (BSPHARMACY)
Entity Type:Individual
Prefix:MR
First Name:FELIPE
Middle Name:ROVILLOS
Last Name:RESCOBER
Suffix:JR
Gender:M
Credentials:BSPHARMACY
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:23855 RIDGE POINT CT
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92557-2935
Mailing Address - Country:US
Mailing Address - Phone:951-243-9658
Mailing Address - Fax:
Practice Address - Street 1:9961 SIERRA AVE
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-6720
Practice Address - Country:US
Practice Address - Phone:909-427-5335
Practice Address - Fax:909-427-4902
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CARPH 38196183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist