Provider Demographics
NPI:1336456441
Name:FELIX-JOHN CHARLES, JEMMA B (PHARMD)
Entity Type:Individual
Prefix:
First Name:JEMMA
Middle Name:B
Last Name:FELIX-JOHN CHARLES
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 1:9094 GRAMERCY DR
Mailing Address - Street 2:APT 165
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-2373
Mailing Address - Country:US
Mailing Address - Phone:619-659-1085
Mailing Address - Fax:
Practice Address - Street 1:1665 ALPINE BLVD
Practice Address - Street 2:
Practice Address - City:ALPINE
Practice Address - State:CA
Practice Address - Zip Code:91901-3859
Practice Address - Country:US
Practice Address - Phone:619-659-1085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-10
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62514183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist