Provider Demographics
NPI:1144473471
Name:DEHNER, MATTHEW E (PHARM D)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:E
Last Name:DEHNER
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11945 HANDRICH DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-1411
Mailing Address - Country:US
Mailing Address - Phone:661-747-6988
Mailing Address - Fax:
Practice Address - Street 1:11945 HANDRICH DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-1411
Practice Address - Country:US
Practice Address - Phone:661-747-6988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-30
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA570981835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy