MEDICARE: LINDSEY HERNANDEZ VALENZUELA 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
1	183500000X	Pharmacist	58385	CA

General Provider Information

NPI Number	:	1629268180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSEY HERNANDEZ VALENZUELA PHARM D

Provider Business Mailing Address
First Line	:	68860 PEREZ RD STE J
Second Line	:	CATHEDRAL CITY
City	:	CATHEDRAL CITY
State	:	CA
Zip	:	92234-7248
Country	:	US
Telephone Number	:	760-328-4499
Fax Number	:	760-328-2230

Provider Business Practice Location Address
First Line	:	35325 DATE PALM DR. #209
Second Line	:	CATHEDRAL CITY
City	:	CATHEDRAL CITY
State	:	CA
Zip	:	92234-7248
Country	:	US
Telephone Number	:	760-328-4499
Fax Number	:	760-328-2230

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

Provider Enumeration Date	:	07/30/2007
Last Update Date	:	07/30/2007

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