Provider Demographics
NPI:1669512265
Name:WEBB, TERENCE LLOYD (PHARMD, MBA)
Entity type:Individual
Prefix:DR
First Name:TERENCE
Middle Name:LLOYD
Last Name:WEBB
Suffix:
Gender:M
Credentials:PHARMD, MBA
Other - Prefix:DR
Other - First Name:TERRY
Other - Middle Name:
Other - Last Name:WEBB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD, MBA
Mailing Address - Street 1:24353 WILDWOOD GLEN LN
Mailing Address - Street 2:
Mailing Address - City:ALPINE
Mailing Address - State:CA
Mailing Address - Zip Code:91901-1800
Mailing Address - Country:US
Mailing Address - Phone:619-445-1470
Mailing Address - Fax:619-445-1473
Practice Address - Street 1:655 EUCLID AVE STE 305
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-2976
Practice Address - Country:US
Practice Address - Phone:619-955-5236
Practice Address - Fax:619-262-3716
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40357183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist