Provider Demographics
NPI:1982316261
Name:STAMP, AUSTIN (PHARM D)
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:
Last Name:STAMP
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 1:18192 PATRICIA CT
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95033-8929
Mailing Address - Country:US
Mailing Address - Phone:408-384-1720
Mailing Address - Fax:
Practice Address - Street 1:2203 MISSION ST
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-5221
Practice Address - Country:US
Practice Address - Phone:831-420-0781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86696183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist