Healthcare Provider Details

I. General information

NPI: 1083655146
Provider Name (Legal Business Name): MICHAEL D HUTCHISON PHARM.D.,CDM
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

714 F ST
EUREKA CA
95501-1036
US

IV. Provider business mailing address

2075 BURU PL
EUREKA CA
95503-7318
US

V. Phone/Fax

Practice location:
  • Phone: 707-268-2448
  • Fax: 707-442-4023
Mailing address:
  • Phone: 707-268-2447
  • Fax: 707-442-4023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number39884
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number9087
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: