Healthcare Provider Details

I. General information

NPI: 1144692195
Provider Name (Legal Business Name): MICHELLE MARQUEZ HSIEH PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2015
Last Update Date: 12/21/2025
Certification Date: 12/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 W COVINA BLVD
SAN DIMAS CA
91773-3245
US

IV. Provider business mailing address

1350 W COVINA BLVD
SAN DIMAS CA
91773-3245
US

V. Phone/Fax

Practice location:
  • Phone: 909-599-6891
  • Fax:
Mailing address:
  • Phone: 909-599-6811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number11400
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number69927
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: