Provider Demographics
NPI:1720839608
Name:SESE, ANGELINO CECIL
Entity Type:Individual
Prefix:
First Name:ANGELINO CECIL
Middle Name:
Last Name:SESE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8238 DEER SPRING CIR
Mailing Address - Street 2:
Mailing Address - City:ANTELOPE
Mailing Address - State:CA
Mailing Address - Zip Code:95843-6118
Mailing Address - Country:US
Mailing Address - Phone:916-833-4842
Mailing Address - Fax:
Practice Address - Street 1:1587 W EL CAMINO AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95833-1992
Practice Address - Country:US
Practice Address - Phone:916-568-1667
Practice Address - Fax:916-568-1619
Is Sole Proprietor?:No
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86841183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist