Provider Demographics
NPI:1336505312
Name:BENDER, ROCIO MAGDALENA (PHARMD)
Entity Type:Individual
Prefix:
First Name:ROCIO
Middle Name:MAGDALENA
Last Name:BENDER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ROCIO
Other - Middle Name:MAGADALENA
Other - Last Name:ORTEGA-ALEMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1550 SUPERIOR AVE
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-3653
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1550 SUPERIOR AVE
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-3653
Practice Address - Country:US
Practice Address - Phone:949-270-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-06
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA72420183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist