Provider Demographics
NPI:1154692986
Name:ADVINCULA, ANN-MARGARET ADVINCULA (RPH)
Entity type:Individual
Prefix:
First Name:ANN-MARGARET
Middle Name:ADVINCULA
Last Name:ADVINCULA
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 1:5001 W AVE N
Mailing Address - Street 2:
Mailing Address - City:QUARTZ HILL
Mailing Address - State:CA
Mailing Address - Zip Code:93536
Mailing Address - Country:US
Mailing Address - Phone:661-722-5892
Mailing Address - Fax:661-943-8062
Practice Address - Street 1:5001 WEST AVE. N
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536
Practice Address - Country:US
Practice Address - Phone:661-722-5892
Practice Address - Fax:661-943-8062
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-25
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62231183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist