Provider Demographics
NPI:1083164495
Name:ROSENTHAL, SARA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:
Last Name:ROSENTHAL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 W G ST # 204
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-6096
Mailing Address - Country:US
Mailing Address - Phone:310-750-8836
Mailing Address - Fax:
Practice Address - Street 1:2662 DEL MAR HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-3100
Practice Address - Country:US
Practice Address - Phone:858-481-8601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-10
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA75640183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist