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NPI Code Detail

MEDICARE: GARY LAIRD PHARMD

MEDICARE:   GARY  LAIRD  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
1183500000XPharmacistRPH46438CA

General Provider Information

NPI Number : 1871889451
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARY LAIRD PHARMD
Provider Business Mailing Address
First Line : 1010 N EL CAMINO REAL
Second Line : TARGET PHARMACY STORE NUMBER T-1029
City : ENCINITAS
State : CA
Zip : 92024-1320
Country : US
Telephone Number : 760-697-9107
Fax Number :
Provider Business Practice Location Address
First Line : 2485 EL CAMINO REAL
Second Line : TARGET PHARMACY STORE NUMBER T-0321
City : REDWOOD CITY
State : CA
Zip : 94063-2849
Country : US
Telephone Number : 650-549-0000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2011
Last Update Date : 12/08/2011

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