Provider Demographics
NPI:1942578075
Name:WEINSTEIN, NINA D (PHARM D)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:D
Last Name:WEINSTEIN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:NINA
Other - Middle Name:
Other - Last Name:DOAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5695 ALTON PKWY
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3237 E CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92869-3709
Practice Address - Country:US
Practice Address - Phone:714-538-5609
Practice Address - Fax:714-538-0335
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-03
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48803183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA48803OtherCALIFORNIA PHARMACIST LICENSE