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General NPI Number Information
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NPI Number | 1568503134
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Entity Type | Individual
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Provider Name | JIMMY RAY NEGRETE RPH
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Gender | Male
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 18525 YORBA LINDA BLVD
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City | YORBA LINDA
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State | CA
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Zip | 92886-4135
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Country | US
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Telephone | 714-777-2737
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Fax | 714-777-9252
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Provider Business Mailing Address
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Address Line | 5582 KERN DR
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92649-4531
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Country | US
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Telephone | 714-846-3854
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Fax | 714-846-3854
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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 | RPH38356
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License Number State | CA
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