Provider Demographics
NPI:1053756916
Name:ORCA, KEVIN A (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:A
Last Name:ORCA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
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Mailing Address - Street 1:900 GREENLEY RD
Mailing Address - Street 2:STE 912
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370-5287
Mailing Address - Country:US
Mailing Address - Phone:209-536-3700
Mailing Address - Fax:209-536-3511
Practice Address - Street 1:900 GREENLEY RD
Practice Address - Street 2:STE 912
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-5287
Practice Address - Country:US
Practice Address - Phone:209-536-3700
Practice Address - Fax:209-536-3511
Is Sole Proprietor?:No
Enumeration Date:2013-05-06
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA67455183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist