Facts
- Status
- A
- Credential
- Pharm D
- Type
- Individual
- Enumeration date
- 2013-07-23
- Last updated
- 2013-07-23
Specialties
Licenses
- License CA
- 58415
Location
- Practice location
- 60 N HIGHLAND SPRINGS AVE
- City
- BANNING CA
- Postal code
- 922203048
- Phone
- 951-845-5984
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
The OIG NPI list is not in this build yet. Confirm on OIG's search.
Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.