Provider Demographics
NPI:1396974564
Name:MANUEL, RIALYN P (CPHT)
Entity type:Individual
Prefix:
First Name:RIALYN
Middle Name:P
Last Name:MANUEL
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1014 OAK HILL DR
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91915-1409
Mailing Address - Country:US
Mailing Address - Phone:619-781-8377
Mailing Address - Fax:
Practice Address - Street 1:1014 OAK HILL DR
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91915-1409
Practice Address - Country:US
Practice Address - Phone:619-781-8377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-09
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42167183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician