Provider Demographics
NPI:1518272160
Name:MOLTHEN, TERI LEE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:TERI
Middle Name:LEE
Last Name:MOLTHEN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11980 TELEGRAPH RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SANTA FE SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:90670-3797
Mailing Address - Country:US
Mailing Address - Phone:877-872-4844
Mailing Address - Fax:866-872-4844
Practice Address - Street 1:11980 TELEGRAPH RD
Practice Address - Street 2:SUITE 102
Practice Address - City:SANTA FE SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:90670-3797
Practice Address - Country:US
Practice Address - Phone:877-872-4844
Practice Address - Fax:866-872-4844
Is Sole Proprietor?:No
Enumeration Date:2010-08-06
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44432183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist