Provider Demographics
NPI:1942788898
Name:TANOVICEANU, ROXANNE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ROXANNE
Middle Name:
Last Name:TANOVICEANU
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 1:3611 W 244TH ST
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-6508
Mailing Address - Country:US
Mailing Address - Phone:424-241-8788
Mailing Address - Fax:
Practice Address - Street 1:1124 W CARSON ST RM 101
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-2006
Practice Address - Country:US
Practice Address - Phone:310-222-7930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-02
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA519601835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist