Healthcare Provider Details
I. General information
NPI: 1376753079
Provider Name (Legal Business Name): JANET AMPARO BALBUTIN PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6240 CLARK ROAD STE.B
PARADISE CA
95969
US
IV. Provider business mailing address
436 W.SHASTA AVENUE
CHICO CA
95926
US
V. Phone/Fax
- Phone: 530-877-4981
- Fax: 530-877-1048
- Phone: 530-893-8962
- Fax: 530-877-1048
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 025833 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: