Provider Demographics
NPI:1215682760
Name:MAAMO, JOSIBEL JUATON (RPH)
Entity type:Individual
Prefix:
First Name:JOSIBEL
Middle Name:JUATON
Last Name:MAAMO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34960 WINTERGRASS CT
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:CA
Mailing Address - Zip Code:92596-8972
Mailing Address - Country:US
Mailing Address - Phone:845-300-4650
Mailing Address - Fax:
Practice Address - Street 1:30251 MURRIETA RD
Practice Address - Street 2:
Practice Address - City:MENIFEE
Practice Address - State:CA
Practice Address - Zip Code:92584-8385
Practice Address - Country:US
Practice Address - Phone:951-244-7210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-14
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA72118183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist