Healthcare Provider Details

I. General information

NPI: 1487010476
Provider Name (Legal Business Name): CASSAUNDRA JO LYNCH PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2016
Last Update Date: 01/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24900 CA-202
TEHACHAPI CA
93561
US

IV. Provider business mailing address

201 E CHAPMAN AVE APT F42
PLACENTIA CA
92870-4650
US

V. Phone/Fax

Practice location:
  • Phone: 661-822-4402
  • Fax:
Mailing address:
  • Phone: 714-334-3428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number74212
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: