Provider Demographics
NPI:1346770153
Name:SCHIMMER, TRAVIS MICHAEL (RPH)
Entity Type:Individual
Prefix:
First Name:TRAVIS
Middle Name:MICHAEL
Last Name:SCHIMMER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 S OXNARD BLVD
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-7419
Mailing Address - Country:US
Mailing Address - Phone:805-483-6510
Mailing Address - Fax:
Practice Address - Street 1:1205 S OXNARD BLVD
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-7419
Practice Address - Country:US
Practice Address - Phone:805-483-6510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-14
Last Update Date:2017-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA757051835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist