Healthcare Provider Details

I. General information

NPI: 1528923620
Provider Name (Legal Business Name): MARIA CELINE ISABEL SOMBILLO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2025
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15210 ROSECRANS AVE
LA MIRADA CA
90638-4735
US

IV. Provider business mailing address

15210 ROSECRANS AVE
LA MIRADA CA
90638-4735
US

V. Phone/Fax

Practice location:
  • Phone: 714-228-0204
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number91785
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: