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General NPI Number Information
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NPI Number | 1407326556
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Entity Type | Individual
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Provider Name | CINDY LY
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Gender | Female
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Dates
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Enumeration Date | 12/03/2018
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Last Update Date | 12/18/2019
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Provider Practice Location Address
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Address Line | 27749 CLINTON KEITH RD
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City | MURRIETA
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State | CA
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Zip | 92562-8552
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Country | US
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Telephone | 951-304-3479
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Fax |
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Provider Business Mailing Address
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Address Line | 22677 RIVERSTONE CIR
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City | WILDOMAR
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State | CA
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Zip | 92595-4900
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Country | US
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Telephone | 951-454-4780
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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 | 79133
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License Number State | CA
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