Provider Demographics
NPI:1346510385
Name:LIVINGSTON, MARK JORDAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:JORDAN
Last Name:LIVINGSTON
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 1:8130 FLORENCE AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90240-3914
Mailing Address - Country:US
Mailing Address - Phone:855-355-1910
Mailing Address - Fax:562-622-3306
Practice Address - Street 1:8130 FLORENCE AVE STE 100
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-3914
Practice Address - Country:US
Practice Address - Phone:855-355-1910
Practice Address - Fax:562-622-3306
Is Sole Proprietor?:No
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 333561835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist