Provider Demographics
NPI:1508146093
Name:ALANIZ, MARISSA BARAWID (PHARMD)
Entity Type:Individual
Prefix:
First Name:MARISSA
Middle Name:BARAWID
Last Name:ALANIZ
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 1:2950 S ARCHIBALD AVE
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91761-7303
Mailing Address - Country:US
Mailing Address - Phone:909-923-9934
Mailing Address - Fax:909-923-0261
Practice Address - Street 1:2950 S ARCHIBALD AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91761-7303
Practice Address - Country:US
Practice Address - Phone:909-923-9934
Practice Address - Fax:909-923-0261
Is Sole Proprietor?:No
Enumeration Date:2011-08-28
Last Update Date:2011-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH45507183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist