Provider Demographics
NPI:1548724552
Name:ABERGEL, JOEL
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:ABERGEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27867 SMYTH DR STE 101
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-6060
Mailing Address - Country:US
Mailing Address - Phone:661-294-4040
Mailing Address - Fax:661-294-4044
Practice Address - Street 1:27867 SMYTH DR STE 101
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-6060
Practice Address - Country:US
Practice Address - Phone:661-294-4040
Practice Address - Fax:661-294-4044
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH41192183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist