Provider Demographics
NPI:1548625544
Name:MARQUEZ, ELISABETH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ELISABETH
Middle Name:
Last Name:MARQUEZ
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 1:20180 US HIGHWAY 18
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-2919
Mailing Address - Country:US
Mailing Address - Phone:760-946-3335
Mailing Address - Fax:760-946-2634
Practice Address - Street 1:20180 US HIGHWAY 18
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-2919
Practice Address - Country:US
Practice Address - Phone:760-946-3335
Practice Address - Fax:760-946-2634
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-18
Last Update Date:2017-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69094183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist