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General NPI Number Information
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NPI Number | 1831820125
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Entity Type | Individual
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Provider Name | ATHENA ELENI XIDES PHARMD
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Gender | Female
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Dates
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Enumeration Date | 06/18/2022
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Last Update Date | 06/18/2022
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Provider Practice Location Address
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Address Line | 32980 ALVARADO NILES RD STE 836
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City | UNION CITY
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State | CA
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Zip | 94587-3186
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Country | US
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Telephone | 800-552-5520
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Fax |
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Provider Business Mailing Address
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Address Line | 6705 CORTE DEL VISTA
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City | PLEASANTON
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State | CA
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Zip | 94566
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Country | US
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Telephone | 925-918-2039
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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 | 72562
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License Number State | CA
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