Provider Demographics
NPI:1265439426
Name:UNIKEL, EDMUND MARK (PHARMD)
Entity type:Individual
Prefix:DR
First Name:EDMUND
Middle Name:MARK
Last Name:UNIKEL
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:PO BOX 1377
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93062-1377
Mailing Address - Country:US
Mailing Address - Phone:310-386-5986
Mailing Address - Fax:805-581-2797
Practice Address - Street 1:2237 OAK HAVEN AVE
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-5021
Practice Address - Country:US
Practice Address - Phone:310-386-5986
Practice Address - Fax:805-581-2797
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 374591835P1200X, 1835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Not Answered1835P1300XPharmacy Service ProvidersPharmacistPsychiatric