Healthcare Provider Details

I. General information

NPI: 1003497181
Provider Name (Legal Business Name): CHIARA SANDRI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2021
Last Update Date: 04/20/2021
Certification Date: 04/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1363 E VISTA WAY
VISTA CA
92084-4041
US

IV. Provider business mailing address

1174 CAPRISE DR
SAN MARCOS CA
92078-1034
US

V. Phone/Fax

Practice location:
  • Phone: 760-726-1909
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberINT44793
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: