Provider Demographics
NPI:1669991899
Name:DITMARS, LINDSAY Y (PHARM D)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:Y
Last Name:DITMARS
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 1:7545 CHARMANT DR. #1322
Mailing Address - Street 2:1322
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122
Mailing Address - Country:US
Mailing Address - Phone:530-276-4131
Mailing Address - Fax:
Practice Address - Street 1:7545 CHARMANT DR. #1322
Practice Address - Street 2:1322
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122
Practice Address - Country:US
Practice Address - Phone:530-276-4131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-19
Last Update Date:2017-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA77121183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist