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General NPI Number Information
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NPI Number | 1174246896
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Entity Type | Individual
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Provider Name | VINA JOMARIE FAMULERAS DE VERA PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/20/2022
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 2115 ARTESIA BLVD
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City | REDONDO BEACH
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State | CA
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Zip | 90278-3013
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Country | US
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Telephone | 424-408-6006
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Fax |
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Provider Business Mailing Address
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Address Line | 1263 W SONYA LN UNIT 207
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City | SANTA MARIA
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State | CA
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Zip | 93458-6602
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Country | US
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Telephone | 714-443-8724
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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 | 86828
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License Number State | CA
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