Provider Demographics
NPI:1457802266
Name:MARTIN, EDITH HASHIMOTO (PHARMD)
Entity Type:Individual
Prefix:
First Name:EDITH
Middle Name:HASHIMOTO
Last Name:MARTIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3186 ROSE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-5905
Mailing Address - Country:US
Mailing Address - Phone:805-541-8043
Mailing Address - Fax:
Practice Address - Street 1:3186 ROSE AVE
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-5905
Practice Address - Country:US
Practice Address - Phone:805-541-8043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-17
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH37333183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist