Provider Demographics
NPI:1215224001
Name:GRECIA, WILHELMINA BASCO (RPH)
Entity Type:Individual
Prefix:MS
First Name:WILHELMINA
Middle Name:BASCO
Last Name:GRECIA
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 1:4854 LINARO DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-3533
Mailing Address - Country:US
Mailing Address - Phone:714-527-4054
Mailing Address - Fax:562-274-0064
Practice Address - Street 1:4854 LINARO DR
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-3533
Practice Address - Country:US
Practice Address - Phone:562-274-0064
Practice Address - Fax:562-274-0064
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42089183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist