Provider Demographics
NPI:1043618770
Name:PASTINA, PAUL (PHARM D CGP)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:
Last Name:PASTINA
Suffix:
Gender:M
Credentials:PHARM D CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 PINNACLE CT
Mailing Address - Street 2:115
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94801-4199
Mailing Address - Country:US
Mailing Address - Phone:510-235-4246
Mailing Address - Fax:
Practice Address - Street 1:1400 PINNACLE CT
Practice Address - Street 2:115
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94801-4199
Practice Address - Country:US
Practice Address - Phone:510-235-4246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-11
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28936183500000X
VA36941835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric
No183500000XPharmacy Service ProvidersPharmacist