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NPI Code Detail

MEDICARE: GLECY TESICO

MEDICARE: GLECY TESICO
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
1183500000XPharmacistRPH 55690CA

General Provider Information

NPI Number : 1427580745
Entity Type Code : Individual
Provider Name (Legal Business Name) : GLECY TESICO
Provider Business Mailing Address
First Line : 47 VIA LA MORRA
Second Line :
City : AMERICAN CANYON
State : CA
Zip : 94503-1421
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1550 GATEWAY BLVD
Second Line :
City : FAIRFIELD
State : CA
Zip : 94533-6901
Country : US
Telephone Number : 707-427-4155
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2017
Last Update Date : 03/19/2026

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Directions to “ GLECY TESICO ” Practice Location

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