Healthcare Provider Details

I. General information

NPI: 1851234496
Provider Name (Legal Business Name): JOSEPH VIVO PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2026
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8215 VAN NUYS BLVD STE 102
PANORAMA CITY CA
91402-4846
US

IV. Provider business mailing address

3616 GLENRIDGE DR
SHERMAN OAKS CA
91423-4639
US

V. Phone/Fax

Practice location:
  • Phone: 818-787-4490
  • Fax: 818-787-4494
Mailing address:
  • Phone: 818-605-4252
  • Fax: 818-787-4490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number30634
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: