Provider Demographics
NPI:1720229776
Name:KNIGHT, LAURA (RPH)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:
Last Name:KNIGHT
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 1:2737 SANDPIPER DR
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-4737
Mailing Address - Country:US
Mailing Address - Phone:949-278-9468
Mailing Address - Fax:949-453-9733
Practice Address - Street 1:115 TECHNOLOGY DR
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-2408
Practice Address - Country:US
Practice Address - Phone:949-278-9468
Practice Address - Fax:949-453-9733
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-19
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46609183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist