Provider Demographics
NPI:1154649663
Name:THEIN, ZIN MAR (RPH)
Entity Type:Individual
Prefix:MRS
First Name:ZIN MAR
Middle Name:
Last Name:THEIN
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 1:3218 S MANITOBA DR
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-6637
Mailing Address - Country:US
Mailing Address - Phone:714-933-8371
Mailing Address - Fax:
Practice Address - Street 1:2240 SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-5301
Practice Address - Country:US
Practice Address - Phone:310-325-0868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-07
Last Update Date:2010-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 62895183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist