Provider Demographics
NPI:1669772158
Name:BEDNAR, MARIA (RPH)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:
Last Name:BEDNAR
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 1:19730 SUNSET VISTA RD
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-5326
Mailing Address - Country:US
Mailing Address - Phone:909-595-3720
Mailing Address - Fax:
Practice Address - Street 1:4200 CHINO HILLS PKWY
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-3776
Practice Address - Country:US
Practice Address - Phone:909-548-2827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-29
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44275183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist