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NPI Code Detail

MEDICARE: GELSONS MARKETS

MEDICARE: GELSONS MARKETS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336C0003XCommunity/Retail Pharmacy54001CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12155567OTHERPK

General Provider Information

NPI Number : 1326094798
Entity Type Code : Organization
Provider Name (Legal Business Name) : GELSONS MARKETS
Provider Business Mailing Address
First Line : 1736 E AVENIDA DE LOS ARBOLES
Second Line :
City : THOUSAND OAKS
State : CA
Zip : 91362-1301
Country : US
Telephone Number : 805-493-8001
Fax Number : 805-493-5490
Provider Business Practice Location Address
First Line : 1736 E AVENIDA DE LOS ARBOLES
Second Line :
City : THOUSAND OAKS
State : CA
Zip : 91362-1301
Country : US
Telephone Number : 805-493-8001
Fax Number : 805-493-5490
Authorized Official
Title or Position : PRES
Name : ROBERT MCDOUGALL
Credential :
Telephone Number : 818-906-5721
Provider Enumeration Date : 05/26/2006
Last Update Date : 06/16/2016

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Practice Location Address:
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1073945010 — LAURA TERESA DAVILA
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Practice Fax:
1679946396 — BAILEY THOMPSON
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1811538762 — BRIANNA JONES RBT
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Directions to “GELSONS MARKETS ” Practice Location

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