Provider Demographics
NPI:1770222887
Name:CASTRO, MELIZA FERMIN (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:MELIZA
Middle Name:FERMIN
Last Name:CASTRO
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 1:2505 MARSHALYNN WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-7643
Mailing Address - Country:US
Mailing Address - Phone:916-687-1392
Mailing Address - Fax:
Practice Address - Street 1:2505 MARSHALYNN WAY
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-7643
Practice Address - Country:US
Practice Address - Phone:916-687-1392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-27
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86074183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist