Healthcare Provider Details

I. General information

NPI: 1477436210
Provider Name (Legal Business Name): ELIZABETH C MARIN PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2025
Last Update Date: 07/29/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26686 PORTOLA PKWY
FOOTHILL RANCH CA
92610-1755
US

IV. Provider business mailing address

29434 ANA MARIA LN
LAGUNA NIGUEL CA
92677-1736
US

V. Phone/Fax

Practice location:
  • Phone: 949-470-4630
  • Fax:
Mailing address:
  • Phone: 949-243-6867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number39846
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: