Provider Demographics
NPI:1174823223
Name:BOYER, STEVE (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:
Last Name:BOYER
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2747 EL CAMINITO
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-2934
Mailing Address - Country:US
Mailing Address - Phone:818-249-4840
Mailing Address - Fax:
Practice Address - Street 1:655 N FAIR OAKS AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91103-3383
Practice Address - Country:US
Practice Address - Phone:626-578-1336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY29376183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist