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General NPI Number Information
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NPI Number | 1265856959
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Entity Type | Individual
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Provider Name | JUDEA MINTALAR
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Gender | Female
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Dates
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Enumeration Date | 02/14/2014
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Last Update Date | 03/19/2026
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Provider Practice Location Address
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Address Line | 975 SERENO DR
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City | VALLEJO
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State | CA
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Zip | 94589-2441
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Country | US
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Telephone | 707-651-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 512 SILVER OAK TRL
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City | AMERICAN CANYON
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State | CA
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Zip | 94503-3126
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Country | US
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Telephone |
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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 | 69816
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License Number State | CA
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