Healthcare Provider Details

I. General information

NPI: 1053472670
Provider Name (Legal Business Name): VALERIE LINDEBORG PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9961 SIERRA AVE
FONTANA CA
92335-6720
US

IV. Provider business mailing address

9961 SIERRA AVENUE
FONTANA CA
92335
US

V. Phone/Fax

Practice location:
  • Phone: 909-427-4947
  • Fax: 909-427-5452
Mailing address:
  • Phone: 909-427-4947
  • Fax: 909-427-5452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License NumberRPH42822
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: