Provider Demographics
NPI:1447418439
Name:SCHAAN, GINA Q
Entity Type:Individual
Prefix:MRS
First Name:GINA
Middle Name:Q
Last Name:SCHAAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1480 OLD JANAL RANCH RD
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91915-1607
Mailing Address - Country:US
Mailing Address - Phone:619-482-0289
Mailing Address - Fax:
Practice Address - Street 1:1480 OLD JANAL RANCH RD
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91915-1607
Practice Address - Country:US
Practice Address - Phone:619-482-0289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4771183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician