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NPI Code Detail

MEDICARE: DR. ELISSA CORAZON CRUZ PHARM.D.

MEDICARE:  DR. ELISSA CORAZON CRUZ  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
1183500000XPharmacist56087CA

General Provider Information

NPI Number : 1578830949
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELISSA CORAZON CRUZ PHARM.D.
Provider Business Mailing Address
First Line : 3460 EL CAMINO REAL
Second Line :
City : SANTA CLARA
State : CA
Zip : 95051-2809
Country : US
Telephone Number : 408-261-1047
Fax Number :
Provider Business Practice Location Address
First Line : 3460 EL CAMINO REAL
Second Line :
City : SANTA CLARA
State : CA
Zip : 95051-2809
Country : US
Telephone Number : 408-261-1047
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2011
Last Update Date : 11/29/2011

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Directions to “ DR. ELISSA CORAZON CRUZ PHARM.D.” Practice Location

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