Healthcare Provider Details

I. General information

NPI: 1265439426
Provider Name (Legal Business Name): EDMUND MARK UNIKEL PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/02/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2237 OAK HAVEN AVE
SIMI VALLEY CA
93063-5021
US

IV. Provider business mailing address

PO BOX 1377
SIMI VALLEY CA
93062-1377
US

V. Phone/Fax

Practice location:
  • Phone: 310-386-5986
  • Fax: 805-581-2797
Mailing address:
  • Phone: 310-386-5986
  • Fax: 805-581-2797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberRPH 37459
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License NumberRPH 37459
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: