Provider Demographics
NPI:1356964761
Name:TANIGUCHI, ALLEN (PHARM D)
Entity type:Individual
Prefix:
First Name:ALLEN
Middle Name:
Last Name:TANIGUCHI
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12476 SPRING CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93021
Mailing Address - Country:US
Mailing Address - Phone:805-901-4099
Mailing Address - Fax:
Practice Address - Street 1:12476 SPRING CREEK RD
Practice Address - Street 2:
Practice Address - City:MOORPARK
Practice Address - State:CA
Practice Address - Zip Code:93021
Practice Address - Country:US
Practice Address - Phone:805-901-4099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-20
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30514183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist