Provider Demographics
NPI:1639593007
Name:VILLAGRAN, CHRISTINA (PHARM D)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:VILLAGRAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4815 MISSION BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-3917
Mailing Address - Country:US
Mailing Address - Phone:858-273-2108
Mailing Address - Fax:858-273-5542
Practice Address - Street 1:4315 MISSION BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-3917
Practice Address - Country:US
Practice Address - Phone:858-273-2108
Practice Address - Fax:858-273-5542
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-06
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54276183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist