Provider Demographics
NPI:1801188198
Name:SMITH-DUNHAM, CINDI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CINDI
Middle Name:
Last Name:SMITH-DUNHAM
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 1:1540 FROOM RANCH WAY
Mailing Address - Street 2:PHARMACY
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93405-7211
Mailing Address - Country:US
Mailing Address - Phone:805-541-7028
Mailing Address - Fax:805-541-7025
Practice Address - Street 1:1540 FROOM RANCH WAY
Practice Address - Street 2:PHARMACY
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93405-7211
Practice Address - Country:US
Practice Address - Phone:805-541-7028
Practice Address - Fax:805-541-7025
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-05
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 39752183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist