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Individual

FRED PAUL BESIO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
790 S CLOVERDALE BLVD, CLOVERDALE, CA 95425-4010
(707) 894-4414
(707) 894-9379
Mailing address
790 S CLOVERDALE BLVD, CLOVERDALE, CA 95425-4010
(707) 894-4414
(707) 894-9379

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
RPH 30988
CA
3336C0003X
Community/Retail Pharmacy
Primary
PHY365300
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PHA365300
CA
Enumeration date
12/30/2008
Last updated
03/27/2009
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