Provider Demographics
NPI:1205807799
Name:LUTTICKEN, CHRISTINE E (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:E
Last Name:LUTTICKEN
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 1:13131 TAWNY WAY
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-1112
Mailing Address - Country:US
Mailing Address - Phone:858-385-1662
Mailing Address - Fax:
Practice Address - Street 1:13131 TAWNY WAY
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-1112
Practice Address - Country:US
Practice Address - Phone:858-385-1662
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48717183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist