Provider Demographics
NPI:1326634353
Name:DAVIS, JOSEPH HENRY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:HENRY
Last Name:DAVIS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12629 CLALLAM RD
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92308-7154
Mailing Address - Country:US
Mailing Address - Phone:760-553-5181
Mailing Address - Fax:760-242-8617
Practice Address - Street 1:15863 KASOTA RD STE C
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-4507
Practice Address - Country:US
Practice Address - Phone:760-242-5452
Practice Address - Fax:760-242-8617
Is Sole Proprietor?:No
Enumeration Date:2020-12-14
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA81529183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist