Provider Demographics
NPI:1952288623
Name:EL NORTE PHARMACY
Entity type:Organization
Organization Name:EL NORTE PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTAPHNOUS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:951-305-6015
Mailing Address - Street 1:1000 E LATHAM AVE STE D
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-4409
Mailing Address - Country:US
Mailing Address - Phone:951-305-6015
Mailing Address - Fax:951-305-6027
Practice Address - Street 1:1000 E LATHAM AVE STE D
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-4409
Practice Address - Country:US
Practice Address - Phone:951-305-6015
Practice Address - Fax:951-305-6027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-16
Last Update Date:2025-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy