Provider Demographics
NPI:1518374628
Name:OWENS, GLENDA S (RPH)
Entity Type:Individual
Prefix:MS
First Name:GLENDA
Middle Name:S
Last Name:OWENS
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 1:28904 SCOTSVIEW DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-4744
Mailing Address - Country:US
Mailing Address - Phone:310-994-3725
Mailing Address - Fax:
Practice Address - Street 1:28904 SCOTSVIEW DR
Practice Address - Street 2:
Practice Address - City:RANCHO PALOS VERDES
Practice Address - State:CA
Practice Address - Zip Code:90275-4744
Practice Address - Country:US
Practice Address - Phone:310-994-3725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31731183500000X
MD08400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist