Healthcare Provider Details

I. General information

NPI: 1982984100
Provider Name (Legal Business Name): MRS. MICHELLE UYS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2011
Last Update Date: 08/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30340 HAUN RD T2471
MENIFEE CA
92584-6806
US

IV. Provider business mailing address

30340 HAUN RD T2471
MENIFEE CA
92584-6806
US

V. Phone/Fax

Practice location:
  • Phone: 951-723-6152
  • Fax: 951-723-6163
Mailing address:
  • Phone: 951-723-6152
  • Fax: 951-723-6163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number56684
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: