Individual
EGLIS ISMAR TELLEZ-CORRALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1020 29TH ST STE 690, SACRAMENTO, CA 95816-5126
(916) 887-4670
Mailing address
2350 HARBOR BLVD APT 103, COSTA MESA, CA 92626-6258
Taxonomy
Speciality
Code
Description
License number
State
1835P2201X
Ambulatory Care Pharmacist
Primary
62476
CA
Other
Enumeration date
06/25/2013
Last updated
03/06/2025
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