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NPI Code Detail

MEDICARE: DR. GREG ENGELIEN PHARMD

MEDICARE: DR. GREG ENGELIEN PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist65547CA

General Provider Information

NPI Number : 1366894792
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GREG ENGELIEN PHARMD
Provider Business Mailing Address
First Line : 42155 WASHINGTON ST
Second Line :
City : PALM DESERT
State : CA
Zip : 92211-8006
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 42155 WASHINGTON ST
Second Line :
City : PALM DESERT
State : CA
Zip : 92211-8006
Country : US
Telephone Number : 760-345-3259
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2016
Last Update Date : 07/11/2016

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