Provider Demographics
NPI:1780288431
Name:CRUZ, LUIS ROBINSON ANG (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LUIS ROBINSON
Middle Name:ANG
Last Name:CRUZ
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633 ASCOT DR APT 67
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92083-4218
Mailing Address - Country:US
Mailing Address - Phone:951-764-4064
Mailing Address - Fax:
Practice Address - Street 1:200 MERCY CIRCLE
Practice Address - Street 2:H-200
Practice Address - City:CAMP PENDLETON
Practice Address - State:CA
Practice Address - Zip Code:92055
Practice Address - Country:US
Practice Address - Phone:760-719-3578
Practice Address - Fax:760-725-0231
Is Sole Proprietor?:No
Enumeration Date:2020-11-23
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV20592183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist