Provider Demographics
NPI:1003123134
Name:ORTEGA, MARU CEDRIK (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:MARU
Middle Name:CEDRIK
Last Name:ORTEGA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44900 WINCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-2579
Mailing Address - Country:US
Mailing Address - Phone:800-323-6832
Mailing Address - Fax:
Practice Address - Street 1:44900 WINCHESTER RD
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590
Practice Address - Country:US
Practice Address - Phone:800-323-6832
Practice Address - Fax:855-270-7347
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-10
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54915183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist