Provider Demographics
NPI:1891084539
Name:CALAMBRO, SUSANA DY (RPH)
Entity Type:Individual
Prefix:
First Name:SUSANA
Middle Name:DY
Last Name:CALAMBRO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 N EATON AVE
Mailing Address - Street 2:APT. 12
Mailing Address - City:DINUBA
Mailing Address - State:CA
Mailing Address - Zip Code:93618-1641
Mailing Address - Country:US
Mailing Address - Phone:559-643-1869
Mailing Address - Fax:
Practice Address - Street 1:2200 E. EL MONTE WAY
Practice Address - Street 2:RITE AID
Practice Address - City:DINUBA
Practice Address - State:CA
Practice Address - Zip Code:93618
Practice Address - Country:US
Practice Address - Phone:559-591-1401
Practice Address - Fax:559-591-0977
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63773183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist