Provider Demographics
NPI:1558627463
Name:ANGELO, LOUISE JEREMIA GATCHALIAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LOUISE JEREMIA
Middle Name:GATCHALIAN
Last Name:ANGELO
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 1:9434 TWIN TRAILS DR
Mailing Address - Street 2:UNIT 201
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-2628
Mailing Address - Country:US
Mailing Address - Phone:858-335-1740
Mailing Address - Fax:
Practice Address - Street 1:9434 TWIN TRAILS DR
Practice Address - Street 2:UNIT 201
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92129
Practice Address - Country:US
Practice Address - Phone:858-335-1740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-04
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27183390200000X
CA722161835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program