MEDICARE: REXEL BACLIG DOLOPO

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	183700000X	Pharmacy Technician	350101060358007	CA
2	183700000X	Pharmacy Technician	TCH 52113	CA

General Provider Information

NPI Number	:	1457666893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REXEL BACLIG DOLOPO

Provider Business Mailing Address
First Line	:	5324 ANGLER PL
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92154-5810
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5324 ANGLER PL
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92154-5810
Country	:	US
Telephone Number	:	619-482-4537
Fax Number	:

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

Provider Enumeration Date	:	08/10/2010
Last Update Date	:	08/10/2010

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Directions to “ REXEL BACLIG DOLOPO ” Practice Location

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