Provider Demographics
NPI:1841053493
Name:ABE, PATRICIA (PHARMD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:ABE
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 1:580 E CHANNEL RD
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90402-1344
Mailing Address - Country:US
Mailing Address - Phone:310-648-0623
Mailing Address - Fax:
Practice Address - Street 1:2040 CAMFIELD AVE
Practice Address - Street 2:
Practice Address - City:COMMERCE
Practice Address - State:CA
Practice Address - Zip Code:90040-1502
Practice Address - Country:US
Practice Address - Phone:877-462-2582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA419261835C0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835C0207XPharmacy Service ProvidersPharmacistCompounded Sterile Preparations
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA41926OtherBOARD OF PHARMACY