Provider Demographics
NPI:1003268426
Name:BALL, JOHN (PHARMACIST (PHARMD))
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:BALL
Suffix:
Gender:M
Credentials:PHARMACIST (PHARMD)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 WHITTIER BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90023-1708
Mailing Address - Country:US
Mailing Address - Phone:562-773-3285
Mailing Address - Fax:323-268-1940
Practice Address - Street 1:3400 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90023-1708
Practice Address - Country:US
Practice Address - Phone:562-773-3285
Practice Address - Fax:323-268-1940
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-09
Last Update Date:2016-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45550183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist