Healthcare Provider Details

I. General information

NPI: 1396189361
Provider Name (Legal Business Name): DONDREIA L GELIOS PHARM.D., BCPS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2013
Last Update Date: 04/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5909 POSO CT
BAKERSFIELD CA
93309-1458
US

IV. Provider business mailing address

5909 POSO CT
BAKERSFIELD CA
93309-1458
US

V. Phone/Fax

Practice location:
  • Phone: 661-340-3619
  • Fax:
Mailing address:
  • Phone: 661-340-3619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number48735
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number0202205943
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: