Healthcare Provider Details

I. General information

NPI: 1255661245
Provider Name (Legal Business Name): GEORGE PHILIP GLATZEL JR. PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2010
Last Update Date: 12/07/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22486 LAKE HELEN PL
COTTONWOOD CA
96022-7715
US

IV. Provider business mailing address

22486 LAKE HELEN PL
COTTONWOOD CA
96022-7715
US

V. Phone/Fax

Practice location:
  • Phone: 530-347-0947
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number55271
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: