Healthcare Provider Details

I. General information

NPI: 1427083179
Provider Name (Legal Business Name): MARGARET MARY PANELLA-SPANGLER RPH, MS, RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18880 CHERRY VALLEY BLVD
TUOLUMNE CA
95379-9506
US

IV. Provider business mailing address

19427 CORDELIA AVE
SONORA CA
95370-7532
US

V. Phone/Fax

Practice location:
  • Phone: 209-928-5407
  • Fax: 209-928-5413
Mailing address:
  • Phone: 209-928-5407
  • Fax: 209-328-5413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number39900
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: