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General NPI Number Information
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NPI Number | 1063924652
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Entity Type | Individual
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Provider Name | AMANDA LYNN AVEY PHARMD
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Gender | Female
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Dates
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Enumeration Date | 11/03/2017
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Last Update Date | 11/03/2017
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Provider Practice Location Address
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Address Line | 22633 SAVI RANCH PKWY
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City | YORBA LINDA
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State | CA
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Zip | 92887-4647
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Country | US
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Telephone | 714-279-1580
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Fax |
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Provider Business Mailing Address
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Address Line | 1847 TEMESCAL AVE
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City | NORCO
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State | CA
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Zip | 92860-3057
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Country | US
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Telephone | 951-847-1190
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 77635
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License Number State | CA
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