Provider Demographics
NPI:1053611475
Name:HETTINGER, CLAIRE ABELARDO (PHARMD)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:ABELARDO
Last Name:HETTINGER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:ABELARDO
Other - Last Name:PADUNAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4627 CARMEL MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-6613
Mailing Address - Country:US
Mailing Address - Phone:858-523-1847
Mailing Address - Fax:858-523-1842
Practice Address - Street 1:4627 CARMEL MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-6613
Practice Address - Country:US
Practice Address - Phone:858-523-1847
Practice Address - Fax:858-523-1842
Is Sole Proprietor?:No
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58527183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist