MEDICARE: JILLIAN CASSEL PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	69773	CA

General Provider Information

NPI Number	:	1346613858
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILLIAN CASSEL PHARMD

Provider Business Mailing Address
First Line	:	1039 EL CAMINO REAL
Second Line	:
City	:	REDWOOD CITY
State	:	CA
Zip	:	94063-1690
Country	:	US
Telephone Number	:	650-780-9910
Fax Number	:	650-780-9913

Provider Business Practice Location Address
First Line	:	1039 EL CAMINO REAL
Second Line	:
City	:	REDWOOD CITY
State	:	CA
Zip	:	94063-1690
Country	:	US
Telephone Number	:	650-780-9910
Fax Number	:	650-780-9913

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2015
Last Update Date	:	11/05/2015

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Directions to “ JILLIAN CASSEL PHARMD” Practice Location

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