Provider Demographics
NPI:1427228360
Name:ANG, TEE-BOI (RPH)
Entity Type:Individual
Prefix:
First Name:TEE-BOI
Middle Name:
Last Name:ANG
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 1:7060 CLAIREMONT MESA BLVD
Mailing Address - Street 2:1ST FLOOR OUT PATIENT PHARMACY
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-1003
Mailing Address - Country:US
Mailing Address - Phone:858-573-5301
Mailing Address - Fax:858-573-5592
Practice Address - Street 1:7060 CLAIREMONT MESA BLVD
Practice Address - Street 2:1ST FLOOR OUT PATIENT PHARMACY
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-1003
Practice Address - Country:US
Practice Address - Phone:858-573-5301
Practice Address - Fax:858-573-5592
Is Sole Proprietor?:No
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH36193183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist