Healthcare Provider Details

I. General information

NPI: 1083969224
Provider Name (Legal Business Name): RALPH ANTHONY OLIVIER JR. PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2012
Last Update Date: 07/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23550 LYONS AVE
NEWHALL CA
91321-2520
US

IV. Provider business mailing address

19855 TERRI DR
CANYON COUNTRY CA
91351-4817
US

V. Phone/Fax

Practice location:
  • Phone: 661-255-7987
  • Fax:
Mailing address:
  • Phone: 661-251-2612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number41392
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: