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NPI Code Detail

MEDICARE: MS. LYNDA PON RPH

MEDICARE: MS. LYNDA PON RPH
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
1183500000XPharmacist35974CA

General Provider Information

NPI Number : 1790192995
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LYNDA PON RPH
Provider Business Mailing Address
First Line : 3006 ENCHANTED WALK
Second Line :
City : SACRAMENTO
State : CA
Zip : 95835-2669
Country : US
Telephone Number : 530-301-4830
Fax Number :
Provider Business Practice Location Address
First Line : 3521 DEL PASO RD
Second Line :
City : SACRAMENTO
State : CA
Zip : 95835-2800
Country : US
Telephone Number : 916-515-1866
Fax Number : 916-515-0746
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2014
Last Update Date : 07/20/2014

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