Healthcare Provider Details

I. General information

NPI: 1427640937
Provider Name (Legal Business Name): MARY ELIZABETH DOUZJIAN PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2021
Last Update Date: 02/05/2021
Certification Date: 02/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 SANTA FLORENCIA
SOLANA BEACH CA
92075-1514
US

IV. Provider business mailing address

910 SANTA FLORENCIA
SOLANA BEACH CA
92075-1514
US

V. Phone/Fax

Practice location:
  • Phone: 858-999-1247
  • Fax: 855-575-9211
Mailing address:
  • Phone: 858-999-1247
  • Fax: 855-575-9211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number40380
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: