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General NPI Number Information
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NPI Number | 1003554957
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Entity Type | Individual
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Provider Name | JUSTIN R GALLAHER PHARMD
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Gender | Male
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Dates
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Enumeration Date | 05/20/2022
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Last Update Date | 05/20/2022
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Provider Practice Location Address
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Address Line | 9000 MING AVE STE A
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City | BAKERSFIELD
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State | CA
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Zip | 93311-1319
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Country | US
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Telephone | 661-663-0171
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Fax |
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Provider Business Mailing Address
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Address Line | 301 DUMONT DR
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City | BAKERSFIELD
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State | CA
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Zip | 93312-7080
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Country | US
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Telephone | 559-709-8367
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 85727
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License Number State | CA
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