Healthcare Provider Details

I. General information

NPI: 1790997740
Provider Name (Legal Business Name): THERESA ANITA HANDOJO PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 09/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1943 FALSTONE AVE
HACIENDA HTS CA
91745-3503
US

IV. Provider business mailing address

1943 FALSTONE AVE
HACIENDA HTS CA
91745-3503
US

V. Phone/Fax

Practice location:
  • Phone: 626-272-0660
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH 49760
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: