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General NPI Number Information
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NPI Number | 1346568441
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Entity Type | Individual
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Provider Name | MARITZA PETERS RPH
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Gender | Female
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Dates
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Enumeration Date | 05/13/2010
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Last Update Date | 05/13/2010
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Provider Practice Location Address
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Address Line | 14168 US HIGHWAY 395
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City | ADELANTO
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State | CA
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Zip | 92301-6700
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Country | US
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Telephone | 760-246-3524
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Fax | 760-246-3621
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Provider Business Mailing Address
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Address Line | 13521 BETSY ROSS CT
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City | FONTANA
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State | CA
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Zip | 92336-3423
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Country | US
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Telephone | 909-899-0554
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Fax | 760-246-3621
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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 | 36146
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License Number State | CA
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