Provider Demographics
NPI:1053494500
Name:LUMASAG, REBECCA FRANCISCO (BS)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:FRANCISCO
Last Name:LUMASAG
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:2119 BASE LINE RD
Mailing Address - Street 2:
Mailing Address - City:LA VERNE
Mailing Address - State:CA
Mailing Address - Zip Code:91750-2228
Mailing Address - Country:US
Mailing Address - Phone:909-593-6238
Mailing Address - Fax:562-401-6592
Practice Address - Street 1:7601 IMPERIAL HWY
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-3456
Practice Address - Country:US
Practice Address - Phone:562-401-7235
Practice Address - Fax:562-401-6592
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 46992183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist