Provider Demographics
NPI:1154798734
Name:BOLIN, SYLVIA (RPH)
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:BOLIN
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:PO BOX 9971
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92375-3171
Mailing Address - Country:US
Mailing Address - Phone:951-440-5500
Mailing Address - Fax:
Practice Address - Street 1:9493 GARFIELD ST
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3765
Practice Address - Country:US
Practice Address - Phone:951-299-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-30
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48145183500000X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist