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General NPI Number Information
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NPI Number | 1053862375
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Entity Type | Individual
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Provider Name | STUART GRATZ
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Gender | Male
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Dates
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Enumeration Date | 10/21/2016
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Last Update Date | 10/21/2016
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Provider Practice Location Address
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Address Line | 8 GLEN ECHO
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City | DOVE CANYON
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State | CA
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Zip | 92679-3500
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Country | US
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Telephone | 949-459-2565
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Fax |
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Provider Business Mailing Address
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Address Line | 8 GLEN ECHO
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City | DOVE CANYON
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State | CA
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Zip | 92679-3500
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Country | US
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Telephone | 949-459-2565
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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 | RP028979L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PHA0020334
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS52117
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0014144
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License Number State | OR
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