Provider Demographics
NPI:1023243524
Name:CRUZ, MARJU S (RPH)
Entity type:Individual
Prefix:MRS
First Name:MARJU
Middle Name:S
Last Name:CRUZ
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 1:1637 N VERMONT AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-5312
Mailing Address - Country:US
Mailing Address - Phone:323-664-9854
Mailing Address - Fax:323-664-0512
Practice Address - Street 1:1637 N VERMONT AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-5312
Practice Address - Country:US
Practice Address - Phone:323-664-9854
Practice Address - Fax:323-664-0512
Is Sole Proprietor?:No
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH60902183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist