MEDICARE: DR. CHARLENE COLTON PHARMD

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	61559	CA

General Provider Information

NPI Number	:	1225562796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLENE COLTON PHARMD

Provider Business Mailing Address
First Line	:	21572 PLANO TRABUCO RD
Second Line	:
City	:	TRABUCO CANYON
State	:	CA
Zip	:	92679-3465
Country	:	US
Telephone Number	:	949-589-3792
Fax Number	:	949-589-2705

Provider Business Practice Location Address
First Line	:	21572 PLANO TRABUCO RD
Second Line	:
City	:	TRABUCO CANYON
State	:	CA
Zip	:	92679-3465
Country	:	US
Telephone Number	:	949-589-3792
Fax Number	:	949-589-2705

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

Provider Enumeration Date	:	04/11/2017
Last Update Date	:	04/11/2017

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