Healthcare Provider Details

I. General information

NPI: 1972836047
Provider Name (Legal Business Name): ROBERT L DEAMER PHARMD, BCPS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2009
Last Update Date: 09/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2060 TAPO ST
SIMI VALLEY CA
93063-3417
US

IV. Provider business mailing address

2355 WATERTOWN CT
THOUSAND OAKS CA
91360-1976
US

V. Phone/Fax

Practice location:
  • Phone: 805-522-3733
  • Fax:
Mailing address:
  • Phone: 805-236-4941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberRPH 037370
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: