Provider Demographics
NPI:1477829539
Name:ZONARAS, DAWN DOREEN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:DOREEN
Last Name:ZONARAS
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 1:12269 RAGWEED ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-4106
Mailing Address - Country:US
Mailing Address - Phone:858-484-7632
Mailing Address - Fax:
Practice Address - Street 1:4605 MORENA BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-3650
Practice Address - Country:US
Practice Address - Phone:858-581-4550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-22
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40901183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist