Provider Demographics
NPI:1992930812
Name:DYER, NOEMIE GALANG (RPH)
Entity type:Individual
Prefix:MRS
First Name:NOEMIE
Middle Name:GALANG
Last Name:DYER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32261 MISSION TRL
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92530-4577
Mailing Address - Country:US
Mailing Address - Phone:951-674-0301
Mailing Address - Fax:951-674-8621
Practice Address - Street 1:32261 MISSION TRL
Practice Address - Street 2:
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92530-4577
Practice Address - Country:US
Practice Address - Phone:951-674-0301
Practice Address - Fax:951-674-8621
Is Sole Proprietor?:No
Enumeration Date:2009-05-20
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53330183500000X
ARPD10382183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist