Provider Demographics
NPI:1053606608
Name:SALAZAR, DONALD GEORGE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:GEORGE
Last Name:SALAZAR
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3520 TYLER ST
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-4175
Mailing Address - Country:US
Mailing Address - Phone:951-351-1083
Mailing Address - Fax:951-351-1083
Practice Address - Street 1:3520 TYLER ST
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-4175
Practice Address - Country:US
Practice Address - Phone:951-351-1083
Practice Address - Fax:951-351-1083
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-11
Last Update Date:2011-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53630183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist