Provider Demographics
NPI:1619947934
Name:BIAGGI, IGGDY ENID (PHARMACIST)
Entity Type:Individual
Prefix:MRS
First Name:IGGDY
Middle Name:ENID
Last Name:BIAGGI
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:MRS
Other - First Name:IGGDY
Other - Middle Name:ENID
Other - Last Name:SANTIAGO-BIAGGI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMACIST
Mailing Address - Street 1:34800 BOB WILSON DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92134
Mailing Address - Country:US
Mailing Address - Phone:858-577-9960
Mailing Address - Fax:858-577-7651
Practice Address - Street 1:BMC MCAS, MIRAMIR PHARMACY
Practice Address - Street 2:BUILDING 2496 BAUER RD
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92145
Practice Address - Country:US
Practice Address - Phone:858-577-9960
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47861183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist