Provider Demographics
NPI:1144770561
Name:PABLO, ERIN JHULE DENOSTA (PHARMD)
Entity Type:Individual
Prefix:
First Name:ERIN JHULE
Middle Name:DENOSTA
Last Name:PABLO
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 1:2121 N D ST
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92405-3915
Mailing Address - Country:US
Mailing Address - Phone:909-266-2546
Mailing Address - Fax:909-494-5582
Practice Address - Street 1:2121 N D ST
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92405-3915
Practice Address - Country:US
Practice Address - Phone:909-266-2546
Practice Address - Fax:909-494-5582
Is Sole Proprietor?:No
Enumeration Date:2016-10-10
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA74218183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist