Provider Demographics
NPI:1538593280
Name:WESEMULLER, CAROLINE NIZZE (PHARMD)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:NIZZE
Last Name:WESEMULLER
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 1:1120 W ALHAMBRA RD
Mailing Address - Street 2:APT. #103
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-2262
Mailing Address - Country:US
Mailing Address - Phone:951-490-7711
Mailing Address - Fax:
Practice Address - Street 1:777 E COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2104
Practice Address - Country:US
Practice Address - Phone:626-795-5472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-29
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69102183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist