Derderian, Edward John
Derderian, Edward John is an sole proprietor health care provider with primary practice located at 1625 E Elmonte Way , Dinuba CA 93618-1896. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Derderian, Edward John can be contacted via phone (559) 591-6400.Contact Information
Primary practice address
1625 E Elmonte Way
Dinuba CA 93618-1896
Phone: (559) 591-6400
Fax: (559) 591-8439
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Pharmacy Service Providers / Pharmacist | 183500000X | 37486 | California |
Profile Details
| NPI number | 1134220346 |
|---|---|
| LBN Legal business name | Derderian, Edward John |
| Credentials | PHARM.D.; R.PH. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 26th, 2006 |
| Last updated | Jul 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134220346 | NPPES |
| California | MEDICAID | PHA408250 |
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