Provider Demographics
NPI:1568776011
Name:RAZO, ELMA OLAGUER
Entity Type:Individual
Prefix:MISS
First Name:ELMA
Middle Name:OLAGUER
Last Name:RAZO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2311 4TH ST APT 201
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-3456
Mailing Address - Country:US
Mailing Address - Phone:310-210-3183
Mailing Address - Fax:
Practice Address - Street 1:2311 4TH ST APT 201
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90405-3456
Practice Address - Country:US
Practice Address - Phone:310-210-3183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-27
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45151183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist