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General NPI Number Information
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NPI Number | 1922890672
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Entity Type | Individual
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Provider Name | CAMILLE ESPIRITU SANTO MALLILLIN
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Gender | Female
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Dates
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Enumeration Date | 05/20/2025
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 2940 E LA PALMA AVE
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City | ANAHEIM
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State | CA
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Zip | 92806-2619
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Country | US
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Telephone | 714-238-0010
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Fax |
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Provider Business Mailing Address
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Address Line | 12631 GLEN ST
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City | GARDEN GROVE
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State | CA
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Zip | 92840-5420
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Country | US
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Telephone | 714-313-4862
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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 | RPH90947
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License Number State | CA
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