Provider Demographics
NPI:1497998116
Name:MORRIS, PAUL ERVIN (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ERVIN
Last Name:MORRIS
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 1:11255 MOUTAIN VIEW AVENUE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354
Mailing Address - Country:US
Mailing Address - Phone:909-558-3086
Mailing Address - Fax:909-558-3980
Practice Address - Street 1:11255 MOUNTAIN VIEW AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-3864
Practice Address - Country:US
Practice Address - Phone:909-558-3086
Practice Address - Fax:909-558-3980
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-10
Last Update Date:2009-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH26646183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist