Provider Demographics
NPI:1558605915
Name:SANTOS, ESTELLA LIMA (M PHARM)
Entity Type:Individual
Prefix:
First Name:ESTELLA
Middle Name:LIMA
Last Name:SANTOS
Suffix:
Gender:F
Credentials:M PHARM
Other - Prefix:
Other - First Name:ESTELLA
Other - Middle Name:LIMA
Other - Last Name:SANTOS THOMSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3132 FERNCREEK LN
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92027-6747
Mailing Address - Country:US
Mailing Address - Phone:858-353-5023
Mailing Address - Fax:
Practice Address - Street 1:1280 AUTO PARK WAY
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92029-2231
Practice Address - Country:US
Practice Address - Phone:760-489-6119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-23
Last Update Date:2012-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55623183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist