Healthcare Provider Details

I. General information

NPI: 1104309442
Provider Name (Legal Business Name): ILA MAEWAL SAUNDERS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2018
Last Update Date: 09/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3855 HEALTH SCIENCES DR
LA JOLLA CA
92093-1503
US

IV. Provider business mailing address

9500 GILMAN DR # MC0657
LA JOLLA CA
92093-0657
US

V. Phone/Fax

Practice location:
  • Phone: 858-657-7000
  • Fax:
Mailing address:
  • Phone: 858-822-6839
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number58490
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: