JERRY DEPA

PALM DESERT, CA
NPI1164975298
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy183500000X Pharmacist
(Licence: CA  65239)
Additional Taxonomies183500000X Pharmacist
(Licence: NV  12508)
183500000X Pharmacist
(Licence: AZ  S013144)
Enumeration Date2016-07-25
Last Update Date2016-07-25
Business Address
-- JERRY DEPA
39155 WASHINGTON ST
PALM DESERT, CA 92211-1259
Phone number: 760-772-7641
Mailing Address
-- JERRY DEPA
39155 WASHINGTON ST
PALM DESERT, CA 92211-1259
Phone number: 760-772-7641