Provider Demographics
NPI:1659654051
Name:BOYER, AILEEN DOLORITA (PHARM D)
Entity Type:Individual
Prefix:MS
First Name:AILEEN
Middle Name:DOLORITA
Last Name:BOYER
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 1:38787 STONINGTON TER
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-4290
Mailing Address - Country:US
Mailing Address - Phone:510-796-2546
Mailing Address - Fax:
Practice Address - Street 1:2105 MORRILL AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95132-1130
Practice Address - Country:US
Practice Address - Phone:408-263-5550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27662183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist