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NPI 1588156020

NPI 1588156020 : JOHN SKOVMAND : SANTA PAULA, CA

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General NPI Number Information
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    NPI Number           |    1588156020
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    Entity Type          |    Individual 
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    Provider Name        |    JOHN SKOVMAND
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/31/2018
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    Last Update Date     |    05/31/2018
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Provider Practice Location Address
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    Address Line         |    110 W HARVARD BLVD STE H 
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    City                 |    SANTA PAULA
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    State                |    CA
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    Zip                  |    93060-3874
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    Country              |    US
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    Telephone            |    805-525-3313
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    9554 CHAMBERLAIN ST 
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    City                 |    VENTURA
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    State                |    CA
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    Zip                  |    93004-3074
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    Country              |    US
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    Telephone            |    805-279-3916
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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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       |    RPH31708
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    License Number State |    CA
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