Provider Demographics
NPI:1386615474
Name:MARTIN, ALAN JAMES (RPH)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:JAMES
Last Name:MARTIN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3186 ROSE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-5905
Mailing Address - Country:US
Mailing Address - Phone:805-305-2085
Mailing Address - Fax:805-541-8043
Practice Address - Street 1:989 LOS OSOS VALLEY RD
Practice Address - Street 2:
Practice Address - City:LOS OSOS
Practice Address - State:CA
Practice Address - Zip Code:93402-3205
Practice Address - Country:US
Practice Address - Phone:805-528-1017
Practice Address - Fax:805-528-1915
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-28
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA373371835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist