Provider Demographics
NPI:1184738718
Name:WITMORE, DOUGLAS (PHARM D)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:
Last Name:WITMORE
Suffix:
Gender:
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:DOUGLAS
Other - Middle Name:
Other - Last Name:WITMORE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARM D
Mailing Address - Street 1:10 CANARY CT
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94551-3970
Mailing Address - Country:US
Mailing Address - Phone:925-371-7271
Mailing Address - Fax:
Practice Address - Street 1:10 CANARY CT
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94551-3970
Practice Address - Country:US
Practice Address - Phone:925-371-7271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2025-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24115183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist