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General NPI Number Information
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NPI Number | 1649523135
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Entity Type | Individual
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Provider Name | MR. MICHAEL JOHN PALMER
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Gender | Male
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Dates
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Enumeration Date | 10/21/2012
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Last Update Date | 10/21/2012
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Provider Practice Location Address
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Address Line | 2445 ORO DAM BLVD E SUITE 9
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City | OROVILLE
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State | CA
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Zip | 95966-6035
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Country | US
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Telephone | 503-532-9555
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Fax | 530-532-1436
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Provider Business Mailing Address
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Address Line | 112 TUCKER AVE
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City | OROVILLE
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State | CA
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Zip | 95966-9466
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Country | US
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Telephone | 530-534-5348
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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 | 36865
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License Number State | CA
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