Healthcare Provider Details

I. General information

NPI: 1992177935
Provider Name (Legal Business Name): CHELSEA BERGERON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2015
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8080 PARKWAY DR
LA MESA CA
91942-2104
US

IV. Provider business mailing address

8080 PARKWAY DR
LA MESA CA
91942-2104
US

V. Phone/Fax

Practice location:
  • Phone: 866-385-2644
  • Fax:
Mailing address:
  • Phone: 866-385-2644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number71835
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: