Provider Demographics
NPI:1639133689
Name:BLANCAFLOR, BENNET SAMPAYAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BENNET
Middle Name:SAMPAYAN
Last Name:BLANCAFLOR
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6241 CALLE MARISELDA
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92124-1170
Mailing Address - Country:US
Mailing Address - Phone:858-505-9401
Mailing Address - Fax:
Practice Address - Street 1:3481 BOB WILSON DRIVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92134-1113
Practice Address - Country:US
Practice Address - Phone:619-532-8401
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA444181835P1200X
HI15351835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy