Provider Demographics
NPI:1114188851
Name:STAUTZENBERGER, LINDSAY RHEA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:RHEA
Last Name:STAUTZENBERGER
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 1:311 4TH AVE
Mailing Address - Street 2:UNIT 206
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-6967
Mailing Address - Country:US
Mailing Address - Phone:979-450-0815
Mailing Address - Fax:
Practice Address - Street 1:8010 PARKWAY DR
Practice Address - Street 2:CLINICAL PHARMACY SERVICES #1
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-2104
Practice Address - Country:US
Practice Address - Phone:619-589-3467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60177183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist