Provider Demographics
NPI:1821388000
Name:COETZER, ALETTA
Entity Type:Individual
Prefix:MRS
First Name:ALETTA
Middle Name:
Last Name:COETZER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 ORO DAM BLVD E
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95966-5117
Mailing Address - Country:US
Mailing Address - Phone:530-533-8773
Mailing Address - Fax:530-533-8627
Practice Address - Street 1:2700 ORO DAM BLVD E
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95966-5117
Practice Address - Country:US
Practice Address - Phone:530-533-8773
Practice Address - Fax:530-533-8627
Is Sole Proprietor?:No
Enumeration Date:2011-04-09
Last Update Date:2011-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 61985183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist