Provider Demographics
NPI:1699051979
Name:CHERIAN, JOSEPH (PHARMD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:CHERIAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:JOSEPH
Other - Middle Name:
Other - Last Name:CHERIAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:15022 SAN FELICIANO DR
Mailing Address - Street 2:
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-4542
Mailing Address - Country:US
Mailing Address - Phone:714-319-4653
Mailing Address - Fax:
Practice Address - Street 1:3828 SCHAUFELE AVE STE 260
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-1793
Practice Address - Country:US
Practice Address - Phone:562-353-4723
Practice Address - Fax:562-353-4873
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-31
Last Update Date:2024-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA519441835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1699051979Medicaid