Provider Demographics
NPI:1295275931
Name:DAMATO, RICHARD (PHARMD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:DAMATO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:RICK
Other - Middle Name:
Other - Last Name:DAMATO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:5574 EVERGLADES ST
Mailing Address - Street 2:UNIT A
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-6542
Mailing Address - Country:US
Mailing Address - Phone:805-642-0555
Mailing Address - Fax:085-654-0434
Practice Address - Street 1:5574 EVERGLADES ST
Practice Address - Street 2:UNIT A
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-6542
Practice Address - Country:US
Practice Address - Phone:805-642-0555
Practice Address - Fax:085-654-0434
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31963183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist