Provider Demographics
NPI:1770317893
Name:MERCADO, JOVANNY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOVANNY
Middle Name:
Last Name:MERCADO
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 1:7400 CENTER AVE APT 424
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-9182
Mailing Address - Country:US
Mailing Address - Phone:714-274-3092
Mailing Address - Fax:
Practice Address - Street 1:7400 CENTER AVE APT 424
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-9182
Practice Address - Country:US
Practice Address - Phone:714-274-3092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH866041835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology