Provider Demographics
NPI:1356758452
Name:MAGLUNOG, ROXANNE (PHARMD)
Entity type:Individual
Prefix:
First Name:ROXANNE
Middle Name:
Last Name:MAGLUNOG
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 1:7828 VICKY AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91304-4636
Mailing Address - Country:US
Mailing Address - Phone:818-312-2689
Mailing Address - Fax:
Practice Address - Street 1:1720 E CESAR CHAVEZ AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-2536
Practice Address - Country:US
Practice Address - Phone:323-307-8593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-21
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY058657183500000X
CA73062183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist