Provider Demographics
NPI:1609643683
Name:NORMAN, JOSHUA (RPH)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:NORMAN
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 1:9714 CEDAR ST APT B
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-6676
Mailing Address - Country:US
Mailing Address - Phone:562-349-3800
Mailing Address - Fax:
Practice Address - Street 1:13171 MINDANAO WAY
Practice Address - Street 2:
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292-6307
Practice Address - Country:US
Practice Address - Phone:310-821-8908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-08
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA81948183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist