Provider Demographics
NPI:1669855227
Name:MALILAY, LOURDES BILLONES (RPH)
Entity Type:Individual
Prefix:
First Name:LOURDES
Middle Name:BILLONES
Last Name:MALILAY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8791 LANARK CIRCLE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646
Mailing Address - Country:US
Mailing Address - Phone:714-533-2157
Mailing Address - Fax:714-533-7054
Practice Address - Street 1:947 S ANAHEIM BLVD
Practice Address - Street 2:STE 108
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805
Practice Address - Country:US
Practice Address - Phone:714-533-2157
Practice Address - Fax:714-533-7054
Is Sole Proprietor?:No
Enumeration Date:2015-07-01
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH43247183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist