Provider Demographics
NPI:1386392975
Name:SWEIS, KATY (PHARMD)
Entity type:Individual
Prefix:
First Name:KATY
Middle Name:
Last Name:SWEIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:MY
Other - Middle Name:
Other - Last Name:QUACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:45656 CORTE LOBOS
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-1233
Mailing Address - Country:US
Mailing Address - Phone:951-553-8745
Mailing Address - Fax:
Practice Address - Street 1:45656 CORTE LOBOS
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-1233
Practice Address - Country:US
Practice Address - Phone:951-553-8745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83677183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist