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General NPI Number Information
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NPI Number | 1528147626
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Entity Type | Organization
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Legal Business Name | GOLETA VALLEY MEDICAL PHARMACY
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 02/20/2008
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Provider Practice Location Address
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Address Line | 334 S PATTERSON AVE STE 110
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City | SANTA BARBARA
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State | CA
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Zip | 93111-2400
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Country | US
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Telephone | 805-967-5634
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Fax | 805-683-4355
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Provider Business Mailing Address
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Address Line | 334 S PATTERSON AVE STE 110
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City | SANTA BARBARA
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State | CA
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Zip | 93111-2400
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Country | US
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Telephone | 805-967-5634
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Fax | 805-683-4355
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Authorized Official
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Title or Position | PHARMACIST
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Name | MR. JOSEPH ALLEN DE HERRERA
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Credential | RPH
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Telephone | 805-967-5634
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 21795
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License Number State | CA
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