Provider Demographics
NPI:1093130429
Name:WEIL, MARIEFE (RPH)
Entity Type:Individual
Prefix:
First Name:MARIEFE
Middle Name:
Last Name:WEIL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 W CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93637-8759
Mailing Address - Country:US
Mailing Address - Phone:559-661-9470
Mailing Address - Fax:
Practice Address - Street 1:2020 W CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93637-8759
Practice Address - Country:US
Practice Address - Phone:559-661-9470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-21
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA67194183500000X
HIPH2897183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist