MEDICARE: MARIBEL PARRA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	61632	CA

General Provider Information

NPI Number	:	1093175739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIBEL PARRA

Provider Business Mailing Address
First Line	:	711 E MARKET ST
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95202-3104
Country	:	US
Telephone Number	:	209-465-1001
Fax Number	:	209-946-1001

Provider Business Practice Location Address
First Line	:	711 E MARKET ST
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95202-3104
Country	:	US
Telephone Number	:	209-465-1001
Fax Number	:	209-946-1001

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2016
Last Update Date	:	02/23/2016

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Directions to “ MARIBEL PARRA ” Practice Location

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