Provider Demographics
NPI:1679856835
Name:UEDA, JOYCE JUNKO (PHARMD)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:JUNKO
Last Name:UEDA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 S LA BREA AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-3023
Mailing Address - Country:US
Mailing Address - Phone:323-937-9383
Mailing Address - Fax:323-937-9916
Practice Address - Street 1:260 S LA BREA AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-3023
Practice Address - Country:US
Practice Address - Phone:323-937-9383
Practice Address - Fax:323-937-9916
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-23
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 36634183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist