Individual
ANNA THERESE DE LA ROSA MAYOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
914 FAIR OAKS AVE, SOUTH PASADENA, CA 91030-3308
(626) 441-3702
Mailing address
19215 E CAMPTON ST, WEST COVINA, CA 91792-2802
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
83020
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
83020
CALIFORNIA BOARD OF PHARMACY
CA
Enumeration date
09/02/2020
Last updated
09/04/2020
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