Provider Demographics
NPI:1932497542
Name:BABB, ELIZABETH KEESEY (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:KEESEY
Last Name:BABB
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MRS
Other - First Name:ELIZABETH
Other - Middle Name:JOY AFTRETH
Other - Last Name:KEESEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:8010 PARKWAY DRIVE
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942
Mailing Address - Country:US
Mailing Address - Phone:619-589-3158
Mailing Address - Fax:619-589-3266
Practice Address - Street 1:8010 PARKWAY DRIVE
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942
Practice Address - Country:US
Practice Address - Phone:619-589-3158
Practice Address - Fax:619-589-3266
Is Sole Proprietor?:No
Enumeration Date:2011-07-16
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65538183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist