Provider Demographics
NPI:1134540685
Name:ESTAREJA, ALAN ORDAS (RPH)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:ORDAS
Last Name:ESTAREJA
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 1:20288 US HIGHWAY 18
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-2937
Mailing Address - Country:US
Mailing Address - Phone:760-240-5501
Mailing Address - Fax:
Practice Address - Street 1:20288 US HIGHWAY 18
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-2937
Practice Address - Country:US
Practice Address - Phone:760-240-5501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-01
Last Update Date:2014-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA70363183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist