Provider Demographics
NPI:1255631693
Name:MCCARTHY, PAOLA MARIA (RPH)
Entity type:Individual
Prefix:MS
First Name:PAOLA
Middle Name:MARIA
Last Name:MCCARTHY
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 1:260 PINEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PARADISE
Mailing Address - State:CA
Mailing Address - Zip Code:95969-5765
Mailing Address - Country:US
Mailing Address - Phone:530-520-1605
Mailing Address - Fax:530-877-2740
Practice Address - Street 1:6020 CLARK RD
Practice Address - Street 2:
Practice Address - City:PARADISE
Practice Address - State:CA
Practice Address - Zip Code:95969
Practice Address - Country:US
Practice Address - Phone:530-877-7001
Practice Address - Fax:530-877-2740
Is Sole Proprietor?:No
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 45100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARPH45100OtherPHARMACIST WITH NO IDENTIFIERS