Provider Demographics
NPI:1417302431
Name:SMYTH, MEGHAN PURCELL (PHARMD)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:PURCELL
Last Name:SMYTH
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 1:27251 LA PAZ RD
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-3602
Mailing Address - Country:US
Mailing Address - Phone:949-831-4313
Mailing Address - Fax:949-831-4319
Practice Address - Street 1:27251 LA PAZ RD
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-3602
Practice Address - Country:US
Practice Address - Phone:949-831-4313
Practice Address - Fax:949-831-4319
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-27
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA70717183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist