Provider Demographics
NPI:1659189181
Name:TRUJILLO, MASSIEL (PHARM D)
Entity type:Individual
Prefix:
First Name:MASSIEL
Middle Name:
Last Name:TRUJILLO
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2380 OLIVERA RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-1627
Mailing Address - Country:US
Mailing Address - Phone:714-588-6335
Mailing Address - Fax:
Practice Address - Street 1:2380 OLIVERA RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-1627
Practice Address - Country:US
Practice Address - Phone:714-588-6335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA72550183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist