Provider Demographics
NPI:1316520463
Name:PINEDA, IAMIKA- JO CRUZ (PHARMD)
Entity type:Individual
Prefix:DR
First Name:IAMIKA- JO
Middle Name:CRUZ
Last Name:PINEDA
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 1:900 W TEMPLE ST APT 338B
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-4547
Mailing Address - Country:US
Mailing Address - Phone:714-306-7954
Mailing Address - Fax:
Practice Address - Street 1:5467 WILSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-4219
Practice Address - Country:US
Practice Address - Phone:323-525-0646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-05
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84112183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist