Provider Demographics
NPI:1114409281
Name:STONE, ROSLYNN (PHARMD, PHD)
Entity Type:Individual
Prefix:
First Name:ROSLYNN
Middle Name:
Last Name:STONE
Suffix:
Gender:F
Credentials:PHARMD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 S. FREMONT, A10N SUITE 10150, MAILBOX 38
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803
Mailing Address - Country:US
Mailing Address - Phone:619-890-7264
Mailing Address - Fax:626-457-4195
Practice Address - Street 1:1000 S. FREMONT, A10N SUITE 10150
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91803
Practice Address - Country:US
Practice Address - Phone:619-890-7264
Practice Address - Fax:626-457-4195
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-05
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65964183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist