Provider Demographics
NPI:1013466374
Name:ESKANDAR, MINA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MINA
Middle Name:
Last Name:ESKANDAR
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 1:1298 ANTELOPE CREEK DR
Mailing Address - Street 2:#521
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-3607
Mailing Address - Country:US
Mailing Address - Phone:518-506-2513
Mailing Address - Fax:
Practice Address - Street 1:1298 ANTELOPE CREEK DR
Practice Address - Street 2:#521
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-3607
Practice Address - Country:US
Practice Address - Phone:518-506-2513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-28
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA75011183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist