MEDICARE: CHRISTINA VILLAGRAN 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	54276	CA

General Provider Information

NPI Number	:	1639593007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA VILLAGRAN PHARM D

Provider Business Mailing Address
First Line	:	4815 MISSION BLVD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92109-3917
Country	:	US
Telephone Number	:	858-273-2108
Fax Number	:	858-273-5542

Provider Business Practice Location Address
First Line	:	4315 MISSION BLVD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92109-3917
Country	:	US
Telephone Number	:	858-273-2108
Fax Number	:	858-273-5542

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

Provider Enumeration Date	:	02/06/2014
Last Update Date	:	02/06/2014

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