Provider Demographics
NPI:1629611280
Name:BITTERMAN, JOSEPH STEVEN (RPH)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:STEVEN
Last Name:BITTERMAN
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 1:1378 PACIFIC BEACH DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-5212
Mailing Address - Country:US
Mailing Address - Phone:619-977-4330
Mailing Address - Fax:
Practice Address - Street 1:7650 GIRARD AVE
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-4447
Practice Address - Country:US
Practice Address - Phone:858-454-1361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-25
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35177183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist