Healthcare Provider Details

I. General information

NPI: 1679190862
Provider Name (Legal Business Name): DANIEL DE ROBLES PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2020
Last Update Date: 07/03/2020
Certification Date: 07/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32225 TEMECULA PKWY
TEMECULA CA
92592-6811
US

IV. Provider business mailing address

45429 EAGLE CREST LN
TEMECULA CA
92592-1843
US

V. Phone/Fax

Practice location:
  • Phone: 951-506-7613
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number82224
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: