Provider Demographics
NPI:1336639186
Name:SELTZER, JANET LEE (RPH)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:LEE
Last Name:SELTZER
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 1:201 E BOWMAN RD
Mailing Address - Street 2:
Mailing Address - City:RIDGECREST
Mailing Address - State:CA
Mailing Address - Zip Code:93555-8243
Mailing Address - Country:US
Mailing Address - Phone:760-371-4979
Mailing Address - Fax:760-371-3520
Practice Address - Street 1:201 E BOWMAN RD
Practice Address - Street 2:
Practice Address - City:RIDGECREST
Practice Address - State:CA
Practice Address - Zip Code:93555-8243
Practice Address - Country:US
Practice Address - Phone:760-371-4979
Practice Address - Fax:760-371-3520
Is Sole Proprietor?:No
Enumeration Date:2018-05-17
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH19144183500000X
RIRPH05289183500000X
CARPH40750183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist