Provider Demographics
NPI:1285705608
Name:ABRAHAM, JOSEPH E (RPH)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:E
Last Name:ABRAHAM
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5865 QUAIL CT
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455-6034
Mailing Address - Country:US
Mailing Address - Phone:805-748-4440
Mailing Address - Fax:805-310-4515
Practice Address - Street 1:1450 W MCCOY LN STE B
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-1059
Practice Address - Country:US
Practice Address - Phone:805-748-4440
Practice Address - Fax:805-928-6200
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH40844183500000X
CAAPH107311835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA10731OtherBOARD OF PHARMACY
CARPH40844OtherBOARD OF PHARMACY
CARPH40844OtherBOARD OF PHARMACY