Provider Demographics
NPI:1790957009
Name:PAJIMULA, MELANIE PURIFICACION (CPHT)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:PURIFICACION
Last Name:PAJIMULA
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7200 PARKWAY DR
Mailing Address - Street 2:SUITE 104B
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-1534
Mailing Address - Country:US
Mailing Address - Phone:619-433-0903
Mailing Address - Fax:
Practice Address - Street 1:7200 PARKWAY DR
Practice Address - Street 2:SUITE 104B
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-1534
Practice Address - Country:US
Practice Address - Phone:619-433-0903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-26
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA73892183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA73892OtherPHARMACY TECHNICIAN