Provider Demographics
NPI:1144514936
Name:HALLER, BETTY R (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BETTY
Middle Name:R
Last Name:HALLER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6536 VIA SIENA
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-6546
Mailing Address - Country:US
Mailing Address - Phone:310-832-8117
Mailing Address - Fax:310-832-4694
Practice Address - Street 1:6536 VIA SIENA
Practice Address - Street 2:
Practice Address - City:RANCHO PALOS VERDES
Practice Address - State:CA
Practice Address - Zip Code:90275-6546
Practice Address - Country:US
Practice Address - Phone:310-832-8117
Practice Address - Fax:310-832-4694
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA312531835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric