Provider Demographics
NPI:1801141528
Name:LIPP, ROBERT STEPHEN (PHARM D)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:STEPHEN
Last Name:LIPP
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9332 CRYSTAL VIEW DR
Mailing Address - Street 2:
Mailing Address - City:TUJUNGA
Mailing Address - State:CA
Mailing Address - Zip Code:91042-3209
Mailing Address - Country:US
Mailing Address - Phone:818-353-6973
Mailing Address - Fax:818-247-8593
Practice Address - Street 1:1400 W KENNETH RD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91201-1422
Practice Address - Country:US
Practice Address - Phone:818-242-4195
Practice Address - Fax:818-247-8593
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH32284183500000X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy