Provider Demographics
NPI:1245787035
Name:BEMBEN, NINA MICHELLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NINA
Middle Name:MICHELLE
Last Name:BEMBEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:NINA
Other - Middle Name:MICHELLE
Other - Last Name:CIMINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:555 MISSION ROCK ST
Mailing Address - Street 2:#507
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94158-2119
Mailing Address - Country:US
Mailing Address - Phone:734-306-1168
Mailing Address - Fax:
Practice Address - Street 1:555 MISSION ROCK ST
Practice Address - Street 2:#507
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94158-2119
Practice Address - Country:US
Practice Address - Phone:734-306-1168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-08
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD206641835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy