Provider Demographics
NPI:1649539099
Name:ALI, ELIZABETH A (RPH)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:ALI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:A
Other - Last Name:STANKOSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:7312 BORLA PL
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-7802
Mailing Address - Country:US
Mailing Address - Phone:760-846-0124
Mailing Address - Fax:
Practice Address - Street 1:7312 BORLA PL
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-7802
Practice Address - Country:US
Practice Address - Phone:760-846-0124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-04
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49334183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist