MEDICARE: DR. FRED R RALEIGH PHARM.D., BCPP

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
1	1835P1300X	Psychiatric Pharmacist	27362	CA

General Provider Information

NPI Number	:	1881691285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRED R RALEIGH PHARM.D., BCPP

Provider Business Mailing Address
First Line	:	PO BOX 88
Second Line	:
City	:	TEMPLETON
State	:	CA
Zip	:	93465-0088
Country	:	US
Telephone Number	:	805-748-7127
Fax Number	:	800-783-4127

Provider Business Practice Location Address
First Line	:	1940 SPRING ST
Second Line	:	PACT CLINIC
City	:	PASO ROBLES
State	:	CA
Zip	:	93446-1620
Country	:	US
Telephone Number	:	805-239-9595
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	07/08/2007

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