Provider Demographics
NPI:1578044996
Name:ALEXANDRU, ANTOANELA IOANA
Entity Type:Individual
Prefix:
First Name:ANTOANELA IOANA
Middle Name:
Last Name:ALEXANDRU
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 1:1808 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-6661
Mailing Address - Country:US
Mailing Address - Phone:323-392-5695
Mailing Address - Fax:
Practice Address - Street 1:1808 W 7TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-6661
Practice Address - Country:US
Practice Address - Phone:323-392-5695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-23
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA74610183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist