Provider Demographics
NPI:1669711545
Name:TAPIA, GUILLERMO P JR (RPH)
Entity type:Individual
Prefix:
First Name:GUILLERMO
Middle Name:P
Last Name:TAPIA
Suffix:JR
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 1:871 ENBORG CT UNIT 200
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2645
Mailing Address - Country:US
Mailing Address - Phone:408-885-7463
Mailing Address - Fax:
Practice Address - Street 1:871 ENBORG CT
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2645
Practice Address - Country:US
Practice Address - Phone:408-885-7463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-12
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 55211183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist