Provider Demographics
NPI:1619214905
Name:PERSON, JAMES P (RPH)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:P
Last Name:PERSON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 MING AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93304-4522
Mailing Address - Country:US
Mailing Address - Phone:661-831-4050
Mailing Address - Fax:661-831-0366
Practice Address - Street 1:1717 MING AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93304-4522
Practice Address - Country:US
Practice Address - Phone:661-831-4050
Practice Address - Fax:661-831-0366
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38446183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist