Healthcare Provider Details

I. General information

NPI: 1700142254
Provider Name (Legal Business Name): SANDRA LOTZ-WEINER RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SANDY LOTZ-WEINER RPH

II. Dates (important events)

Enumeration Date: 04/10/2012
Last Update Date: 06/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 CARMEL RANCHO BLVD
CARMEL CA
93923-8708
US

IV. Provider business mailing address

2000 CALIFORNIA AVE
SAND CITY CA
93955-3150
US

V. Phone/Fax

Practice location:
  • Phone: 831-624-7173
  • Fax: 831-624-7348
Mailing address:
  • Phone: 831-393-1400
  • Fax: 831-393-1420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number55412
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: