Provider Demographics
NPI:1629617311
Name:FLETCHER-THOMPSON, ELAINE M (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:M
Last Name:FLETCHER-THOMPSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 S EXMOOR AVE
Mailing Address - Street 2:
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90220-4424
Mailing Address - Country:US
Mailing Address - Phone:310-418-0278
Mailing Address - Fax:310-933-8985
Practice Address - Street 1:220 E COMPTON BLVD
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90220-2413
Practice Address - Country:US
Practice Address - Phone:310-604-1747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-30
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36858183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist