Basic Information
Provider Information
NPI: 1063853844
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SENG
FirstName: CHRISTINE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 210 W SAN BERNARDINO RD
Address2:  
City: COVINA
State: CA
PostalCode: 917231515
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 210 W SAN BERNARDINO RD
Address2:  
City: COVINA
State: CA
PostalCode: 917231515
CountryCode: US
TelephoneNumber: 6263317331
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/09/2013
LastUpdateDate: 07/09/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1835P0018X67515CAY Pharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

No ID Information.


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