Provider Demographics
NPI:1942609946
Name:QUIROZ, IRENE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:IRENE
Middle Name:
Last Name:QUIROZ
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 1:255 TORREY PINES CT
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-4308
Mailing Address - Country:US
Mailing Address - Phone:707-246-3897
Mailing Address - Fax:
Practice Address - Street 1:681 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-3612
Practice Address - Country:US
Practice Address - Phone:707-224-7120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-15
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55150183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist