Provider Demographics
NPI:1730635814
Name:GARONG, ANNALIZA CARANDANG (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANNALIZA
Middle Name:CARANDANG
Last Name:GARONG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10067 COSBY WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95757-1735
Mailing Address - Country:US
Mailing Address - Phone:323-708-3262
Mailing Address - Fax:
Practice Address - Street 1:10067 COSBY WAY
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95757-1735
Practice Address - Country:US
Practice Address - Phone:323-708-3262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11781183500000X
CA46409183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist