Provider Demographics
NPI:1245459429
Name:STIMMEL, GLEN L (PHARMD)
Entity type:Individual
Prefix:DR
First Name:GLEN
Middle Name:L
Last Name:STIMMEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:USC SCHOOL OF PHARMACY
Mailing Address - Street 2:1985 ZONAL AVENUE
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90089-0001
Mailing Address - Country:US
Mailing Address - Phone:323-442-1463
Mailing Address - Fax:323-442-1681
Practice Address - Street 1:USC SCHOOL OF PHARMACY
Practice Address - Street 2:1985 ZONAL AVENUE
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90089-0001
Practice Address - Country:US
Practice Address - Phone:323-442-1463
Practice Address - Fax:323-442-1681
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA278831835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric