Healthcare Provider Details

I. General information

NPI: 1740295385
Provider Name (Legal Business Name): PEOPLES PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 04/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31951 DOVE CANYON DR STE F
TRABUCO CANYON CA
92679-3749
US

IV. Provider business mailing address

31951 DOVE CANYON DR STE F
TRABUCO CANYON CA
92679-3749
US

V. Phone/Fax

Practice location:
  • Phone: 949-713-9400
  • Fax: 949-713-9494
Mailing address:
  • Phone: 949-713-9400
  • Fax: 949-713-9494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY47303
License Number StateCA

VIII. Authorized Official

Name: RASHMI MEDIRATTA
Title or Position: PIC
Credential: RPH
Phone: 949-713-9400