Provider Demographics
NPI:1407885551
Name:OESTERMAN, PAUL J (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:J
Last Name:OESTERMAN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 ELLIOTT PEAK AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-7505
Mailing Address - Country:US
Mailing Address - Phone:702-361-4805
Mailing Address - Fax:
Practice Address - Street 1:645 ELLIOTT PEAK AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-7505
Practice Address - Country:US
Practice Address - Phone:702-361-4805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10109183500000X
CA30179183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist