Healthcare Provider Details

I. General information

NPI: 1851331060
Provider Name (Legal Business Name): CHERIE LYNN DILLON PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 07/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 BODIN CIR PHARMACY SERVICE (119)
TRAVIS AFB CA
94535-1801
US

IV. Provider business mailing address

103 BODIN CIR PHARMACY SERVICE (119)
TRAVIS AFB CA
94535-1801
US

V. Phone/Fax

Practice location:
  • Phone: 707-437-1815
  • Fax: 707-437-1822
Mailing address:
  • Phone: 707-437-1820
  • Fax: 707-437-1822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number46807
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: