Provider Demographics
NPI:1225488505
Name:MINGURA, MICHAL (PHARMD)
Entity Type:Individual
Prefix:
First Name:MICHAL
Middle Name:
Last Name:MINGURA
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 1:2575 YORBA LINDA BLVD
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92831-1699
Mailing Address - Country:US
Mailing Address - Phone:714-872-5733
Mailing Address - Fax:
Practice Address - Street 1:3801 HOWE ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5312
Practice Address - Country:US
Practice Address - Phone:510-752-6141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-16
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORTBD183500000X
CA761191835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No183500000XPharmacy Service ProvidersPharmacist