Provider Demographics
NPI:1740322015
Name:MORALES, LYNN THATCHER (RPH)
Entity type:Individual
Prefix:MS
First Name:LYNN
Middle Name:THATCHER
Last Name:MORALES
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 1:2460 W HEIL AVE
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-3530
Mailing Address - Country:US
Mailing Address - Phone:760-455-2596
Mailing Address - Fax:
Practice Address - Street 1:750 N IMPERIAL AVE
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-1914
Practice Address - Country:US
Practice Address - Phone:760-353-2720
Practice Address - Fax:760-353-3591
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 53329183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist