Provider Demographics
NPI:1679855514
Name:OLMSTED, NOREEN (PHARM D)
Entity Type:Individual
Prefix:
First Name:NOREEN
Middle Name:
Last Name:OLMSTED
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:NOREEN
Other - Middle Name:
Other - Last Name:IBRAHIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:18043 SAPONI CT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-1394
Mailing Address - Country:US
Mailing Address - Phone:858-583-4495
Mailing Address - Fax:
Practice Address - Street 1:460 W FELICITA AVE
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-6518
Practice Address - Country:US
Practice Address - Phone:760-735-6025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 50885183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist