Provider Demographics
NPI:1326631078
Name:NELSON, CALUM WINTER (PHARMD, APH, BCPS)
Entity Type:Individual
Prefix:
First Name:CALUM
Middle Name:WINTER
Last Name:NELSON
Suffix:
Gender:M
Credentials:PHARMD, APH, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 SANTA MONICA BLVD STE 570
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2131
Mailing Address - Country:US
Mailing Address - Phone:323-223-7847
Mailing Address - Fax:323-925-1928
Practice Address - Street 1:2020 SANTA MONICA BLVD STE 570
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2131
Practice Address - Country:US
Practice Address - Phone:323-223-7847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-13
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA828941835P1200X
CA112981835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy