Provider Demographics
NPI:1063757771
Name:LANDAZURI, DULCE HUERTERO (PHARMD)
Entity type:Individual
Prefix:
First Name:DULCE
Middle Name:HUERTERO
Last Name:LANDAZURI
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 1:2055 N PERRIS BLVD
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92571-2509
Mailing Address - Country:US
Mailing Address - Phone:951-943-8188
Mailing Address - Fax:
Practice Address - Street 1:2055 N PERRIS BLVD
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92571-2509
Practice Address - Country:US
Practice Address - Phone:951-943-8188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA68153183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist