Provider Demographics
NPI:1609019280
Name:ROSENBLATT, ANGELA L (MS, PHARMD, BCPS)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:L
Last Name:ROSENBLATT
Suffix:
Gender:F
Credentials:MS, PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8265 LAVENDER LN
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92508-3533
Mailing Address - Country:US
Mailing Address - Phone:702-279-0081
Mailing Address - Fax:
Practice Address - Street 1:26250 CACTUS AVENUE
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92555
Practice Address - Country:US
Practice Address - Phone:951-486-4922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-13
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61729183500000X, 1835P0018X, 1835P1200X
NV17425183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy