MEDICARE: INNA VELASQUEZ

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	82495	CA

General Provider Information

NPI Number	:	1649880790
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	INNA VELASQUEZ

Provider Business Mailing Address
First Line	:	2894 E SAN ANGELO RD
Second Line	:
City	:	PALM SPRINGS
State	:	CA
Zip	:	92262-3806
Country	:	US
Telephone Number	:	310-750-5854
Fax Number	:

Provider Business Practice Location Address
First Line	:	43875 WASHINGTON ST STE A
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92211-8249
Country	:	US
Telephone Number	:	760-777-9902
Fax Number	:

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

Provider Enumeration Date	:	08/04/2020
Last Update Date	:	10/19/2020

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Directions to “ INNA VELASQUEZ ” Practice Location

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