Provider Demographics
NPI:1881905990
Name:ISKANDAR, MARLEIN (PHARMACIST)
Entity type:Individual
Prefix:
First Name:MARLEIN
Middle Name:
Last Name:ISKANDAR
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3241 BUTTERCUP LN
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-7787
Mailing Address - Country:US
Mailing Address - Phone:805-484-4830
Mailing Address - Fax:
Practice Address - Street 1:2738 E. THOMPSON BLVD.
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003
Practice Address - Country:US
Practice Address - Phone:805-648-7795
Practice Address - Fax:805-648-2830
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-24
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH62251183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist