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NPI Code Detail

MEDICARE: MR. DEON JOHANNNES VENTER RPH

MEDICARE: MR. DEON JOHANNNES VENTER RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist47804CA

General Provider Information

NPI Number : 1982871257
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DEON JOHANNNES VENTER RPH
Provider Business Mailing Address
First Line : 9482 CALIFORNIA CITY BLVD
Second Line :
City : CALIFORNIA CITY
State : CA
Zip : 93505-2803
Country : US
Telephone Number : 760-373-5268
Fax Number :
Provider Business Practice Location Address
First Line : 9482 CALIFORNIA CITY BLVD
Second Line :
City : CALIFORNIA CITY
State : CA
Zip : 93505-2803
Country : US
Telephone Number : 760-373-5268
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2008
Last Update Date : 05/14/2008

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