Provider Demographics
NPI:1487954855
Name:OSBORNE, MISHA RENE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:MISHA
Middle Name:RENE
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 MICHILLINDA AVE
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-6342
Mailing Address - Country:US
Mailing Address - Phone:626-821-7724
Mailing Address - Fax:626-821-3664
Practice Address - Street 1:618 MICHILLINDA AVE
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-6342
Practice Address - Country:US
Practice Address - Phone:626-821-7724
Practice Address - Fax:626-821-3664
Is Sole Proprietor?:No
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51734183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist