Provider Demographics
NPI:1487772919
Name:CHUA, JOSEFINA BENAVENTE (RPH)
Entity type:Individual
Prefix:MISS
First Name:JOSEFINA
Middle Name:BENAVENTE
Last Name:CHUA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MISS
Other - First Name:JOSEFINA
Other - Middle Name:BENAVENTE
Other - Last Name:CHUA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:11901 176TH ST APT 246
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:CA
Mailing Address - Zip Code:90701-4047
Mailing Address - Country:US
Mailing Address - Phone:562-865-1760
Mailing Address - Fax:
Practice Address - Street 1:1351 S BEACH BLVD STE O
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-1123
Practice Address - Country:US
Practice Address - Phone:562-902-2622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 56711183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist