Provider Demographics
NPI:1053582262
Name:TAMAYO, JOSEPH (PHARMD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:TAMAYO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4650 PALM AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92154-8404
Mailing Address - Country:US
Mailing Address - Phone:619-662-5301
Mailing Address - Fax:619-662-5317
Practice Address - Street 1:4650 PALM AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92154-8404
Practice Address - Country:US
Practice Address - Phone:619-662-5301
Practice Address - Fax:619-662-5317
Is Sole Proprietor?:No
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 49371183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist