MEDICARE: MISS JOSEFINA BENAVENTE CHUA RPH

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	RPH 56711	CA

General Provider Information

NPI Number	:	1487772919
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS JOSEFINA BENAVENTE CHUA RPH

Provider Business Mailing Address
First Line	:	11901 176TH ST APT 246
Second Line	:
City	:	ARTESIA
State	:	CA
Zip	:	90701-4047
Country	:	US
Telephone Number	:	562-865-1760
Fax Number	:

Provider Business Practice Location Address
First Line	:	1351 S BEACH BLVD STE O
Second Line	:
City	:	LA HABRA
State	:	CA
Zip	:	90631-1123
Country	:	US
Telephone Number	:	562-902-2622
Fax Number	:

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

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	07/08/2007

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