Healthcare Provider Details

I. General information

NPI: 1124058417
Provider Name (Legal Business Name): CHRISTINA DEJORAS R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 01/11/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3622 E SOUTHERN AVE SAFEWAY PHARMACY
MESA AZ
85206-2504
US

IV. Provider business mailing address

3622 E SOUTHERN AVE SAFEWAY PHARMACY
MESA AZ
85206-2504
US

V. Phone/Fax

Practice location:
  • Phone: 480-807-8760
  • Fax: 480-807-6900
Mailing address:
  • Phone: 480-807-8760
  • Fax: 480-807-6900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number14044
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: