Provider Demographics
NPI:1942581996
Name:CHATMON, LAWRENCE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:
Last Name:CHATMON
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 1:2310 TELEGRAPH AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94704-1613
Mailing Address - Country:US
Mailing Address - Phone:510-848-5121
Mailing Address - Fax:510-848-5350
Practice Address - Street 1:2310 TELEGRAPH AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704-1613
Practice Address - Country:US
Practice Address - Phone:510-848-5121
Practice Address - Fax:510-848-5350
Is Sole Proprietor?:No
Enumeration Date:2011-09-05
Last Update Date:2011-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58743183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist