Provider Demographics
NPI:1659691178
Name:NOMURA, STANLEY T (PHARM D)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:T
Last Name:NOMURA
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 1:11500 NIMITZ AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-3566
Mailing Address - Country:US
Mailing Address - Phone:424-832-8314
Mailing Address - Fax:424-832-8315
Practice Address - Street 1:11500 NIMITZ AVE
Practice Address - Street 2:PHARMACY DEPT
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-3566
Practice Address - Country:US
Practice Address - Phone:424-832-8314
Practice Address - Fax:424-832-8315
Is Sole Proprietor?:No
Enumeration Date:2010-06-07
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38731183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist