Provider Demographics
NPI:1184923989
Name:BADILLO, MONICA ABO ABO (RPH)
Entity type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:ABO ABO
Last Name:BADILLO
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 1:333 E CINNAMON DR
Mailing Address - Street 2:APT. # 194
Mailing Address - City:LEMOORE
Mailing Address - State:CA
Mailing Address - Zip Code:93245-2885
Mailing Address - Country:US
Mailing Address - Phone:559-924-4184
Mailing Address - Fax:
Practice Address - Street 1:820 N LEMOORE AVE
Practice Address - Street 2:
Practice Address - City:LEMOORE
Practice Address - State:CA
Practice Address - Zip Code:93245-2333
Practice Address - Country:US
Practice Address - Phone:559-925-6027
Practice Address - Fax:559-925-6032
Is Sole Proprietor?:No
Enumeration Date:2011-03-18
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 62388183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist