MEDICARE: DR. AMANDA REINHARZ PHARM D

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	44504	CA

General Provider Information

NPI Number	:	1396174009
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMANDA REINHARZ PHARM D

Provider Business Mailing Address
First Line	:	85 SAN RAPHAEL
Second Line	:
City	:	DANA POINT
State	:	CA
Zip	:	92629-4043
Country	:	US
Telephone Number	:	949-444-4741
Fax Number	:

Provider Business Practice Location Address
First Line	:	85 SAN RAPHAEL
Second Line	:
City	:	DANA POINT
State	:	CA
Zip	:	92629-4043
Country	:	US
Telephone Number	:	949-444-4741
Fax Number	:

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

Provider Enumeration Date	:	11/03/2013
Last Update Date	:	11/03/2013

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