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NPI Code Detail

MEDICARE: DR. PHILIP J GREGORY PHARMD

MEDICARE: DR. PHILIP J GREGORY 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
11835P1200XPharmacotherapy Pharmacist51282CA

General Provider Information

NPI Number : 1891798880
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PHILIP J GREGORY PHARMD
Provider Business Mailing Address
First Line : 982 OXFORD WAY
Second Line :
City : STOCKTON
State : CA
Zip : 95204-3037
Country : US
Telephone Number : 209-946-2374
Fax Number :
Provider Business Practice Location Address
First Line : 3601 PACIFIC AVE
Second Line :
City : STOCKTON
State : CA
Zip : 95211-0110
Country : US
Telephone Number : 209-946-2374
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 07/08/2007

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