Healthcare Provider Details

I. General information

NPI: 1679112908
Provider Name (Legal Business Name): MRS. SEPHORA MFERRI APLOGAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2020
Last Update Date: 01/03/2020
Certification Date: 01/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9665 CAMPO RD
SPRING VALLEY CA
91977-1228
US

IV. Provider business mailing address

9665 CAMPO RD
SPRING VALLEY CA
91977-1228
US

V. Phone/Fax

Practice location:
  • Phone: 619-466-4051
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number76101
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: