Provider Demographics
NPI:1770805996
Name:HUDSON, VICTOR L (PHARM D)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:L
Last Name:HUDSON
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1076 W KERN ST
Mailing Address - Street 2:
Mailing Address - City:TAFT
Mailing Address - State:CA
Mailing Address - Zip Code:93268-2743
Mailing Address - Country:US
Mailing Address - Phone:661-763-3132
Mailing Address - Fax:661-763-5747
Practice Address - Street 1:1076 W KERN ST
Practice Address - Street 2:
Practice Address - City:TAFT
Practice Address - State:CA
Practice Address - Zip Code:93268-2743
Practice Address - Country:US
Practice Address - Phone:661-763-3132
Practice Address - Fax:661-763-5747
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-16
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52490183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist