Provider Demographics
NPI:1558863910
Name:NOBLE, LAWRENCE STEVEN (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:STEVEN
Last Name:NOBLE
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5718 TANNER RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-5237
Mailing Address - Country:US
Mailing Address - Phone:818-621-3877
Mailing Address - Fax:
Practice Address - Street 1:825 N 10TH ST
Practice Address - Street 2:
Practice Address - City:SANTA PAULA
Practice Address - State:CA
Practice Address - Zip Code:93060-1309
Practice Address - Country:US
Practice Address - Phone:805-933-8636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-01
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH36495183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARPH36495OtherSTATE OF CALIFORNIA