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NPI Code Detail

MEDICARE: AILYNNE MAE CARRERA FRUTO PHARM.D.

MEDICARE: AILYNNE MAE CARRERA FRUTO 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
1183500000XPharmacist67636CA

General Provider Information

NPI Number : 1528445673
Entity Type Code : Individual
Provider Name (Legal Business Name) : AILYNNE MAE CARRERA FRUTO PHARM.D.
Provider Business Mailing Address
First Line : 8681 BLANCHE AVE
Second Line :
City : GARDEN GROVE
State : CA
Zip : 92841-3215
Country : US
Telephone Number : 714-600-4880
Fax Number :
Provider Business Practice Location Address
First Line : 8681 BLANCHE AVE
Second Line :
City : GARDEN GROVE
State : CA
Zip : 92841-3215
Country : US
Telephone Number : 714-600-4880
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2015
Last Update Date : 04/28/2015

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Directions to “ AILYNNE MAE CARRERA FRUTO PHARM.D.” Practice Location

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