Provider Demographics
NPI:1407155401
Name:DANIELS, STEPHANIE DELPHINE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:DELPHINE
Last Name:DANIELS
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 1:446 ALTA RD STE 5400
Mailing Address - Street 2:ATTN: IHSC PHARMACY
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92158-0001
Mailing Address - Country:US
Mailing Address - Phone:619-710-8354
Mailing Address - Fax:619-661-6042
Practice Address - Street 1:446 ALTA RD STE 5400
Practice Address - Street 2:ATTN: IHSC PHARMACY
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92158-0001
Practice Address - Country:US
Practice Address - Phone:619-710-8354
Practice Address - Fax:619-661-6042
Is Sole Proprietor?:No
Enumeration Date:2011-03-17
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP444731183500000X, 183500000X
TX49450183500000X
PARPI002260183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist