Provider Demographics
NPI:1548621972
Name:EBROM, BRITTANY (PHARMD)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:EBROM
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 1:1560 W VALLEY PKWY
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92029-2140
Mailing Address - Country:US
Mailing Address - Phone:760-738-9835
Mailing Address - Fax:760-738-1242
Practice Address - Street 1:1560 W VALLEY PKWY
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92029-2140
Practice Address - Country:US
Practice Address - Phone:760-738-9835
Practice Address - Fax:760-738-1242
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-12
Last Update Date:2016-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69359183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist