Provider Demographics
NPI:1861050171
Name:GLASER, TALEEN VERKINE (PHARMD)
Entity type:Individual
Prefix:
First Name:TALEEN
Middle Name:VERKINE
Last Name:GLASER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:TALEEN
Other - Middle Name:VERKINE
Other - Last Name:JERJIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:645 SATURN BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92154-4732
Mailing Address - Country:US
Mailing Address - Phone:619-429-8932
Mailing Address - Fax:619-429-1067
Practice Address - Street 1:645 SATURN BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92154-4732
Practice Address - Country:US
Practice Address - Phone:619-429-8932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-31
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA74028183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist