Provider Demographics
NPI:1659001840
Name:HATAMOFF, ADAM ASHER (PHARMD)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:ASHER
Last Name:HATAMOFF
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27069 VISTA ENCANTADA DR
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91354-2279
Mailing Address - Country:US
Mailing Address - Phone:661-713-0033
Mailing Address - Fax:
Practice Address - Street 1:27983 SECO CANYON RD
Practice Address - Street 2:
Practice Address - City:SAUGUS
Practice Address - State:CA
Practice Address - Zip Code:91350-3872
Practice Address - Country:US
Practice Address - Phone:661-296-0436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84952183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist