Provider Demographics
NPI:1649552308
Name:SOTELO, EVE (PHARM D)
Entity type:Individual
Prefix:
First Name:EVE
Middle Name:
Last Name:SOTELO
Suffix:
Gender:F
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 1:4662 LA FRANCHI LN
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95503-5974
Mailing Address - Country:US
Mailing Address - Phone:707-441-0955
Mailing Address - Fax:
Practice Address - Street 1:1424 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-0134
Practice Address - Country:US
Practice Address - Phone:707-441-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-19
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51193183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist