Provider Demographics
NPI:1740500636
Name:MUZILA, TINA (PHARMD)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:MUZILA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8368 ELK GROVE FLORIN RD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95829-9228
Mailing Address - Country:US
Mailing Address - Phone:916-681-3558
Mailing Address - Fax:
Practice Address - Street 1:8368 ELK GROVE FLORIN RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95829-9228
Practice Address - Country:US
Practice Address - Phone:916-681-3558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH56224183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist