Provider Demographics
NPI:1508295643
Name:UNDERHILL, SYLVIA JEAN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SYLVIA
Middle Name:JEAN
Last Name:UNDERHILL
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 1:9881 OCEANCREST DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-8201
Mailing Address - Country:US
Mailing Address - Phone:714-915-5987
Mailing Address - Fax:
Practice Address - Street 1:9881 OCEANCREST DR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92646-8201
Practice Address - Country:US
Practice Address - Phone:714-915-5987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-08
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32687183500000X
MI5302022167183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist