Provider Demographics
NPI:1013217165
Name:PASSARELLI, MARIELA V (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:MARIELA
Middle Name:V
Last Name:PASSARELLI
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2938 TAPO CANYON RD
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-2171
Mailing Address - Country:US
Mailing Address - Phone:805-285-2516
Mailing Address - Fax:
Practice Address - Street 1:2938 TAPO CANYON RD
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-2171
Practice Address - Country:US
Practice Address - Phone:805-426-6040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57523183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist