Healthcare Provider Details

I. General information

NPI: 1023679115
Provider Name (Legal Business Name): CHRISTOPHER BEJAR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2019
Last Update Date: 06/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26610 YNEZ RD
TEMECULA CA
92591-4697
US

IV. Provider business mailing address

43020 CORTE FRESCA
TEMECULA CA
92592-3069
US

V. Phone/Fax

Practice location:
  • Phone: 951-719-2002
  • Fax: 951-719-2009
Mailing address:
  • Phone: 951-694-8882
  • Fax: 951-694-8882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number80535
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: