MEDICARE: PAULINE L MARQUELING 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	27826	CA

General Provider Information

NPI Number	:	1467584672
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULINE L MARQUELING PHARMD

Provider Business Mailing Address
First Line	:	120 CARLTON AVE
Second Line	:	#39
City	:	LOS GATOS
State	:	CA
Zip	:	95032-2781
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2620 EL CAMINO REAL
Second Line	:
City	:	SANTA CLARA
State	:	CA
Zip	:	95051-3041
Country	:	US
Telephone Number	:	408-241-0919
Fax Number	:	408-241-1202

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

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	07/08/2007

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