Provider Demographics
NPI:1841511987
Name:CAMPOS, CARMELINE YVONNE GUALVEZ (RPH)
Entity type:Individual
Prefix:MRS
First Name:CARMELINE YVONNE
Middle Name:GUALVEZ
Last Name:CAMPOS
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 1:26991 TIMBERLINE TER
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91381-0622
Mailing Address - Country:US
Mailing Address - Phone:661-287-3905
Mailing Address - Fax:661-799-2767
Practice Address - Street 1:7239 WOODMAN AVE
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-2621
Practice Address - Country:US
Practice Address - Phone:818-781-7127
Practice Address - Fax:818-781-9148
Is Sole Proprietor?:No
Enumeration Date:2010-06-11
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARH46618183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist